Provider Demographics
NPI:1134749112
Name:SIVANANDHAM, SINDHUJA (MBBS)
Entity type:Individual
Prefix:DR
First Name:SINDHUJA
Middle Name:
Last Name:SIVANANDHAM
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:SINDHUJA MURALI
Other - Middle Name:
Other - Last Name:KILAPANDAL VENKATRAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:200 S MANCHESTER AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3219
Mailing Address - Country:US
Mailing Address - Phone:714-456-8888
Mailing Address - Fax:
Practice Address - Street 1:101 THE CITY DR S RM 3003
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3201
Practice Address - Country:US
Practice Address - Phone:714-456-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.075614207ZP0102X
CAA191796207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology