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General NPI Number Information
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NPI Number | 1790368702
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Entity Type | Organization
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Legal Business Name | SPRINTER MEDICAL WEST PC
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Dates
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Enumeration Date | 04/28/2021
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 4600 BOHANNON DR STE 100
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City | MENLO PARK
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State | CA
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Zip | 94025-1037
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Country | US
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Telephone | 209-677-7468
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 BOHANNON DR STE 1000
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City | MENLO PARK
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State | CA
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Zip | 94025-1034
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Country | US
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Telephone | 209-677-7468
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARUN VILLIVALAM
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Credential | MD
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Telephone | 209-677-7468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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