Provider Demographics
NPI:1265522569
Name:GOWDA, NANDINI NETKAL (MD)
Entity type:Individual
Prefix:DR
First Name:NANDINI
Middle Name:NETKAL
Last Name:GOWDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NANDINI
Other - Middle Name:NETKAL
Other - Last Name:MADE GOWDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:309 E 2ND ST FL 2
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-1854
Mailing Address - Country:US
Mailing Address - Phone:909-623-6116
Mailing Address - Fax:
Practice Address - Street 1:309 E 2ND ST FL 2
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-1854
Practice Address - Country:US
Practice Address - Phone:909-623-6116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.117040207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine