Provider Demographics
NPI:1427735307
Name:VORUGANTI, INDU SITALA (MD, MS, FRCPC)
Entity type:Individual
Prefix:DR
First Name:INDU
Middle Name:SITALA
Last Name:VORUGANTI
Suffix:
Gender:F
Credentials:MD, MS, FRCPC
Other - Prefix:DR
Other - First Name:INDU
Other - Middle Name:SITALA
Other - Last Name:VORUGANTI MADDALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MS, FRCPC
Mailing Address - Street 1:875 BLAKE WILBUR DR
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-2205
Mailing Address - Country:US
Mailing Address - Phone:650-724-7673
Mailing Address - Fax:
Practice Address - Street 1:3100 DUBLIN BLVD FL 1
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-7213
Practice Address - Country:US
Practice Address - Phone:925-556-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1875802085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology