Provider Demographics
NPI:1548614142
Name:SUNDARARAJAN, YOGAALAKSHMI (MD)
Entity Type:Individual
Prefix:DR
First Name:YOGAALAKSHMI
Middle Name:
Last Name:SUNDARARAJAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133-03 JAMAICA AVENUE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11418
Mailing Address - Country:US
Mailing Address - Phone:718-206-6942
Mailing Address - Fax:
Practice Address - Street 1:2690 S WHITE RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-2077
Practice Address - Country:US
Practice Address - Phone:408-223-8228
Practice Address - Fax:408-223-8338
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA161966207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program