Provider Demographics
NPI:1306938808
Name:SENNIMALAI, GEETHANJALI (MD)
Entity type:Individual
Prefix:
First Name:GEETHANJALI
Middle Name:
Last Name:SENNIMALAI
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 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0302
Practice Address - Country:US
Practice Address - Phone:916-536-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85562207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2237988OtherFIRST HEALTH
CA1855727OtherGREAT WEST
CA2443787OtherUNITED HEALTHCARE
CA90141471OtherPACIFICARE
CAA85562OtherBLUE CROSS
CA000810607403OtherPHCS
CAMCMG343800OtherWESTERN HEALTH ADVANTAGE
CA236151OtherINTERPLAN
CA106127OtherHEALTH NET
CA2748371OtherCIGNA
CA7943605OtherAETNA
CAA85562OtherBLUE CROSS
I06738Medicare UPIN