Healthcare Provider Details

I. General information

NPI: 1295645737
Provider Name (Legal Business Name): PREETHI SRIDHAR MD MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 GRANT RD STE 103
MOUNTAIN VIEW CA
94040-3877
US

IV. Provider business mailing address

2204 GRANT RD STE 103
MOUNTAIN VIEW CA
94040-3877
US

V. Phone/Fax

Practice location:
  • Phone: 650-967-8841
  • Fax: 650-967-8812
Mailing address:
  • Phone: 650-967-8841
  • Fax: 650-967-8812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: PREETHI SRIDHAR
Title or Position: MD
Credential: MD
Phone: 773-495-6542