MEDICARE: SUNIL H. DESAI MD

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	207R00000X	Internal Medicine Physician	MD-20773	HI
2	207R00000X	Internal Medicine Physician	A51233	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174608848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNIL H. DESAI MD

Provider Business Mailing Address
First Line	:	149 CREEDON CIR
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94502-1404
Country	:	US
Telephone Number	:	510-207-6598
Fax Number	:

Provider Business Practice Location Address
First Line	:	149 CREEDON CIR
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94502-1404
Country	:	US
Telephone Number	:	808-243-6050
Fax Number	:

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	04/03/2024

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