=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053809806
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. AMIT SUNEJA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/27/2018
-----------------------------------------------------
Last Update Date | 08/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 PINE STREET SUITE 1250 (PRIVATE OFFICE 3)
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 833-351-8255
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 PINE STREET, SUITE 1250 (PRIVATE OFFICE 3), SAN FR SUITE 1250 (PRIVATE OFFICE 3)
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94111-8000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 833-351-8255
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | A164076
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------