Provider Demographics
NPI:1407892052
Name:BEALL, SUNITA SUDANAGUNTA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNITA
Middle Name:SUDANAGUNTA
Last Name:BEALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:STUDENT HEALTH SERVICE UCSB MC7002
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93106-7002
Mailing Address - Country:US
Mailing Address - Phone:805-893-5361
Mailing Address - Fax:805-893-2758
Practice Address - Street 1:STUDENT HEALTH SERVICE UCSB MC7002
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-7002
Practice Address - Country:US
Practice Address - Phone:805-893-5361
Practice Address - Fax:805-893-2758
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA060492207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA60492AMedicare PIN
CAH03033Medicare UPIN