Healthcare Provider Details

I. General information

NPI: 1619052271
Provider Name (Legal Business Name): EENA DUGGAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 NORRIS CANYON RD STE 220
SAN RAMON CA
94583-5407
US

IV. Provider business mailing address

8019 JORGENSEN LN
PLEASANTON CA
94588-8200
US

V. Phone/Fax

Practice location:
  • Phone: 925-249-9900
  • Fax: 833-760-3950
Mailing address:
  • Phone: 925-249-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA061084
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: