Provider Demographics
NPI:1750469664
Name:CHHUGANI, SUNEETA J (MD)
Entity Type:Individual
Prefix:
First Name:SUNEETA
Middle Name:J
Last Name:CHHUGANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:P
Other - Last Name:TAHILIANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1800 HARRISON ST FL 7
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-3429
Mailing Address - Country:US
Mailing Address - Phone:510-625-6262
Mailing Address - Fax:
Practice Address - Street 1:900 GREENLEY RD
Practice Address - Street 2:SUITE 922
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-5287
Practice Address - Country:US
Practice Address - Phone:209-536-3738
Practice Address - Fax:209-536-3563
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92411207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A924110Medicaid
00A924110Medicare ID - Type Unspecified
CA00A924110Medicaid