Provider Demographics
NPI:1861532475
Name:ATLURI, VIGNATHI (MD,)
Entity type:Individual
Prefix:DR
First Name:VIGNATHI
Middle Name:
Last Name:ATLURI
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 VALLEJO DR
Mailing Address - Street 2:APT 18
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-2800
Mailing Address - Country:US
Mailing Address - Phone:650-888-8319
Mailing Address - Fax:
Practice Address - Street 1:395 VALLEJO DR
Practice Address - Street 2:APT 18
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-2800
Practice Address - Country:US
Practice Address - Phone:650-888-8319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA974512085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology