Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | C131302 | CA |
NPI | 1013123595 |
---|---|
Provider Name | Shalini Yalamanchi |
First Address | Santa Rosa, CA 95403-3634 |
Second Address | Santa Rosa, CA 95403-3634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 12/05/2021 |