Provider Demographics
NPI:1932326998
Name:SUDAN, RAJENDRA SINGH (MD)
Entity Type:Individual
Prefix:
First Name:RAJENDRA
Middle Name:SINGH
Last Name:SUDAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-5014
Mailing Address - Country:US
Mailing Address - Phone:916-983-2828
Mailing Address - Fax:916-983-0148
Practice Address - Street 1:1600 CREEKSIDE DR
Practice Address - Street 2:SUITE 2300
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3444
Practice Address - Country:US
Practice Address - Phone:916-983-2828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35386207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease