Healthcare Provider Details

I. General information

NPI: 1871671453
Provider Name (Legal Business Name): MALATHI ACHARYA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 PORTOLA RD STE F
PORTOLA VALLEY CA
94028-7844
US

IV. Provider business mailing address

2500 MERCED ST
SAN LEANDRO CA
94577-4201
US

V. Phone/Fax

Practice location:
  • Phone: 650-671-2023
  • Fax:
Mailing address:
  • Phone: 510-454-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA64136
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License NumberA64136
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: