Healthcare Provider Details

I. General information

NPI: 1265258818
Provider Name (Legal Business Name): SUNITA NIGAM RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2024
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 MIRANDA AVE
PALO ALTO CA
94304
US

IV. Provider business mailing address

4642 METROPOLITAN WAY
SAN JOSE CA
95135-1533
US

V. Phone/Fax

Practice location:
  • Phone: 650-493-5000
  • Fax:
Mailing address:
  • Phone: 408-646-8479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number398395
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number398395
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: