Provider Demographics
NPI:1508834938
Name:VEERAPPA, NANDEESH (MD)
Entity Type:Individual
Prefix:
First Name:NANDEESH
Middle Name:
Last Name:VEERAPPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 CELESTE DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-2402
Mailing Address - Country:US
Mailing Address - Phone:209-527-6900
Mailing Address - Fax:209-543-6280
Practice Address - Street 1:1320 CELESTE DR
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2402
Practice Address - Country:US
Practice Address - Phone:209-527-6900
Practice Address - Fax:209-543-6280
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86330207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI35361Medicare UPIN