Provider Demographics
NPI:1427014778
Name:RAM, SUNIL K (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:K
Last Name:RAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SUNIL
Other - Middle Name:KUMAR BYRATHI
Other - Last Name:RAMACHANDRIAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7151 E RANCHO VISTA DR UNIT 3004
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-1591
Mailing Address - Country:US
Mailing Address - Phone:480-686-6792
Mailing Address - Fax:480-323-2839
Practice Address - Street 1:2428 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2045
Practice Address - Country:US
Practice Address - Phone:310-315-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA958752085R0202X
AZ363362085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ217714Medicaid
AZZ115675Medicare PIN
AZZ115674Medicare PIN