Healthcare Provider Details

I. General information

NPI: 1487902524
Provider Name (Legal Business Name): SHILPA JAYARAMASWAMY SULOCHANA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHILPA SULOCHANA SHILPA SULOCHANA MD

II. Dates (important events)

Enumeration Date: 08/21/2012
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39500 FREMONT BLVD STE 100
FREMONT CA
94538-2101
US

IV. Provider business mailing address

39500 FREMONT BLVD STE 100
FREMONT CA
94538-2101
US

V. Phone/Fax

Practice location:
  • Phone: 510-248-1800
  • Fax: 510-687-1356
Mailing address:
  • Phone: 510-248-1800
  • Fax: 510-687-1356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC201237
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: