Gopala Rao Kolluru, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

A38134 Issued in CA

Practice address

27206 Calaroga Ave
Suite 207
Hayward, CA 94545-4300

Phone

(510) 797-5057

Fax

(510) 797-5058

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Washington Township Hospital District

  • General Acute Care Hospital
  • Fremont, CA
  • NPI 1154472058
  Medicare reassignment NPD
• Washington Township Hospital District

  • General Acute Care Hospital
  • Fremont, CA
  • NPI 1679624407
  NPD
• University Healthcare Alliance

  • Family Medicine Physician
  • San Pablo, CA
  • NPI 1043246481

  Cardiovascular Disease

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1164500682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2287 MOWRY AVE",
            "address_2": "SUITE B",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381622",
            "telephone_number": "510-797-5057",
            "fax_number": "510-797-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27206 CALAROGA AVE",
            "address_2": "SUITE 207",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945454300",
            "telephone_number": "510-797-5057",
            "fax_number": "510-797-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLURU",
        "first_name": "GOPALA",
        "middle_name": "RAO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A38134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A381340",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A3813410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric S Kohleriter, M.D.
• Kohli G DDS Inc
• Kelsey Salter Kohlman
• Kokua Toxicology, LLC
• Nadezha Kolbert
• Tanush Koneru
• Chararath Kong
• Shirley Kong
• Anna Belle Kosiarek
• Olga Kournoutas, D.D.S.

• Cardiovascular Disease Physician in Hayward, CA
• Providers in Hayward, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.