Provider Demographics
NPI:1750389250
Name:VEMPATY, HYMA TANIKELLA (MD)
Entity type:Individual
Prefix:DR
First Name:HYMA
Middle Name:TANIKELLA
Last Name:VEMPATY
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 1:13304 GLEN BRAE DR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4431
Mailing Address - Country:US
Mailing Address - Phone:408-741-8367
Mailing Address - Fax:408-851-4319
Practice Address - Street 1:710 LAWRENCE EXPY
Practice Address - Street 2:KAISER PERMANENTE
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5173
Practice Address - Country:US
Practice Address - Phone:408-851-4304
Practice Address - Fax:408-851-4319
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2022-01-04
Deactivation Date:2005-09-13
Deactivation Code:
Reactivation Date:2007-03-28
Provider Licenses
StateLicense IDTaxonomies
CAA61497207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ26779ZMedicare ID - Type UnspecifiedWALNUT CREEK
CAZZZ39156ZMedicare ID - Type UnspecifiedSAN LEANDRO
H00382Medicare UPIN
CAZZZ39149ZMedicare ID - Type UnspecifiedCONCORD
CAZZZ39155ZMedicare ID - Type UnspecifiedANTIOCH