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NPI Code Detail

MEDICARE: SUNEETHA DEVI JAGARLAMUDI M.D.

MEDICARE: SUNEETHA DEVI JAGARLAMUDI M.D.
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
1207Q00000XFamily Medicine PhysicianA78229CA
2207Q00000XFamily Medicine Physician0101256708VA

General Provider Information

NPI Number : 1205862588
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUNEETHA DEVI JAGARLAMUDI M.D.
Provider Business Mailing Address
First Line : 751 S BASCOM AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95128-2699
Country : US
Telephone Number : 408-885-5000
Fax Number :
Provider Business Practice Location Address
First Line : 751 S BASCOM AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95128-2699
Country : US
Telephone Number : 408-885-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2006
Last Update Date : 12/15/2023

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