Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | A119737 | CA |
NPI | 1033362041 |
---|---|
Provider Name | Preethi Chakravarthy Sridhar |
First Address | Mountain View, CA 94040-3855 |
Second Address | Mountain View, CA 94040-3855 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2008 |
Last Update Date | 11/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
HH205Z | MEDICARE PTAN (01) | CA |