Provider Demographics
NPI:1497827745
Name:CHERUKURI, SUDHAKAR V (MD)
Entity Type:Individual
Prefix:
First Name:SUDHAKAR
Middle Name:V
Last Name:CHERUKURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2425 ENBORG LANE
Mailing Address - Street 2:SANTA CLARA VALLEY MEDICAL CENTER
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2648
Mailing Address - Country:US
Mailing Address - Phone:408-885-5400
Mailing Address - Fax:408-885-4055
Practice Address - Street 1:2425 ENBORG LANE
Practice Address - Street 2:SANTA CLARA VALLEY MEDICAL CENTER
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95128-2648
Practice Address - Country:US
Practice Address - Phone:408-885-5400
Practice Address - Fax:408-885-4055
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA96644207RA0401X, 207W00000X
CA966442083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology