MEDICARE: DR. BINDU SUNDAR D.O, PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT28737	CA
2	208100000X	Physical Medicine & Rehabilitation Physician	14819	CA

General Provider Information

NPI Number	:	1063564854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BINDU SUNDAR D.O, PT

Provider Business Mailing Address
First Line	:	3701 BROADWAY FL 5
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94611-5613
Country	:	US
Telephone Number	:	510-752-1244
Fax Number	:	510-752-6244

Provider Business Practice Location Address
First Line	:	3701 BROADWAY FL 5
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94611-5613
Country	:	US
Telephone Number	:	510-752-1244
Fax Number	:	510-752-2562

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	02/09/2022

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