Healthcare Provider Details
I. General information
NPI: 1861048209
Provider Name (Legal Business Name): SUDHA KARUPAIAH MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2019
Last Update Date: 08/20/2021
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
560 E SAINT JOHN ST
SAN JOSE CA
95112-3413
US
IV. Provider business mailing address
560 E SAINT JOHN ST
SAN JOSE CA
95112-3413
US
V. Phone/Fax
- Phone: 408-279-1400
- Fax: 408-279-3216
- Phone: 408-279-1400
- Fax: 408-279-3216
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUDHA
KARUPAIAH
Title or Position: OWNER
Credential: MD
Phone: 408-279-1400