Healthcare Provider Details

I. General information

NPI: 1396657276
Provider Name (Legal Business Name): SHANKAR NARAYANA MUNDLURU, MBA, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2175 3RD STREET UNIT C1
SAN FRANCISCO CA
94107
US

IV. Provider business mailing address

660 KING ST UNIT 313
SAN FRANCISCO CA
94107-1544
US

V. Phone/Fax

Practice location:
  • Phone: 817-726-6366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SHANKAR NARAYANA MUNDLURU
Title or Position: CEO, OWNER
Credential: MD
Phone: 817-726-6366