Provider Demographics
NPI:1780607838
Name:SUNDAR, SHALINI (MD)
Entity type:Individual
Prefix:
First Name:SHALINI
Middle Name:
Last Name:SUNDAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHALINI
Other - Middle Name:
Other - Last Name:PATIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:39233 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1501
Mailing Address - Country:US
Mailing Address - Phone:510-795-8186
Mailing Address - Fax:
Practice Address - Street 1:39233 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1501
Practice Address - Country:US
Practice Address - Phone:510-795-8186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93518207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine