Healthcare Provider Details

I. General information

NPI: 1366823841
Provider Name (Legal Business Name): KUMAR SUKHDEO M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2015
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 STONERIDGE DR
PLEASANTON CA
94588-4501
US

IV. Provider business mailing address

7601 STONERIDGE DR
PLEASANTON CA
94588-4501
US

V. Phone/Fax

Practice location:
  • Phone: 925-847-5100
  • Fax: 844-469-1474
Mailing address:
  • Phone: 925-847-5100
  • Fax: 844-469-1474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125066625
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number295724-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: