| Dr Praveena Gopinatha Mallya, DO | |
|
795 El Camino Real, Palo Alto, CA 94302-2302 | |
| (650) 853-6558 | |
| Not Available |
| Full Name | Dr Praveena Gopinatha Mallya |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 795 El Camino Real, Palo Alto, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922020635 | NPI | - | NPPES |
| 0219525 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | OS013741 (Pennsylvania) | Secondary |
| 208000000X | Pediatrics | 2OA12814 (California) | Primary |
| Entity Name | Dignity Health Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700803418 PECOS PAC ID: 7810800661 Enrollment ID: O20031107000709 |
| Entity Name | University Of California San Francisco |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861578973 PECOS PAC ID: 4486567229 Enrollment ID: O20031212000897 |
| Entity Name | Ucsf Medical Group Business Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477624104 PECOS PAC ID: 3779497870 Enrollment ID: O20040622001513 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Praveena Gopinatha Mallya, DO 2350 W. El Camino Real, 2nd Floor, Mountain View, CA 94040-6203 Ph: () - | Dr Praveena Gopinatha Mallya, DO 795 El Camino Real, Palo Alto, CA 94302-2302 Ph: (650) 853-6558 |
Jean Chia, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 730 Welch Rd, Palo Alto, CA 94304 Phone: 650-721-6073 | |
Crystal Lee Mackall, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 725 Welch Rd, Palo Alto, CA 94304 Phone: 650-497-8000 | |
Somya Jalan, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 725 Welch Rd, Palo Alto, CA 94304 Phone: 650-497-8000 | |
Erin E Holsinger, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 725 Welch Rd, Palo Alto, CA 94304 Phone: 650-497-8000 | |
Dr. Jerome Linus Murphy, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 725 Welch Rd, Palo Alto, CA 94304 Phone: 650-497-8000 | |
Peter Andrew Meaney, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 725 Welch Rd, Palo Alto, CA 94304 Phone: 650-497-8000 | |
Kenneth Ivers Weinberg, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 725 Welch Rd, Palo Alto, CA 94304 Phone: 650-498-7103 |