Individual
DR. SURENDRA BABU GUDAPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2490 HOSPITAL DR, SUITE 104, MOUNTAIN VIEW, CA 94040-4122
(650) 962-4410
(650) 962-4411
Mailing address
200 JOSE FIGUERES AVE, SUITE 255, SAN JOSE, CA 95116-1500
(408) 223-7474
(408) 223-9339
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A76026
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A760260
BLUE SHIELD PROVIDER ID
CA
Enumeration date
07/07/2006
Last updated
06/14/2013
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