MEDICARE: MALATHI ACHARYA 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
1	207R00000X	Internal Medicine Physician	A64136	CA
2	202D00000X	Integrative Medicine Physician	A64136	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	:	1871671453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALATHI ACHARYA M.D.

Provider Business Mailing Address
First Line	:	2500 MERCED ST
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94577-4201
Country	:	US
Telephone Number	:	510-454-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 PORTOLA RD STE F
Second Line	:
City	:	PORTOLA VALLEY
State	:	CA
Zip	:	94028-7844
Country	:	US
Telephone Number	:	650-671-2023
Fax Number	:

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	01/08/2025

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