Provider Demographics
NPI:1215170915
Name:MAKIM, NEEPA (DO)
Entity type:Individual
Prefix:DR
First Name:NEEPA
Middle Name:
Last Name:MAKIM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT 34929
Mailing Address - Street 2:P.O. BOX 39000
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94139-0001
Mailing Address - Country:US
Mailing Address - Phone:925-952-2828
Mailing Address - Fax:925-952-2850
Practice Address - Street 1:5820 STONERIDGE MALL RD
Practice Address - Street 2:#101
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3274
Practice Address - Country:US
Practice Address - Phone:925-224-0720
Practice Address - Fax:925-224-0722
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.056618208000000X
CA20A13490208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics