Healthcare Provider Details

I. General information

NPI: 1134062003
Provider Name (Legal Business Name): UDESHIKA HANSANI ERAMUDUGOLLA ERAMUDUGOLLE WALAWWE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W HOSPITAL RD
FRENCH CAMP CA
95231-9693
US

IV. Provider business mailing address

870 E EL CAMINO REAL APT 161
MOUNTAIN VIEW CA
94040-2816
US

V. Phone/Fax

Practice location:
  • Phone: 209-468-6624
  • Fax:
Mailing address:
  • Phone: 650-861-1247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: