Provider Demographics
NPI:1013921253
Name:VENUGOPAL, SANDHYA (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDHYA
Middle Name:
Last Name:VENUGOPAL
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 1:4860 Y ST., STE. 2820
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817
Mailing Address - Country:US
Mailing Address - Phone:916-734-5191
Mailing Address - Fax:916-734-8394
Practice Address - Street 1:4860 Y ST
Practice Address - Street 2:SUITE 2820
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-3764
Practice Address - Fax:916-734-8394
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91083207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A910830Medicare PIN
I59280Medicare UPIN