Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | A96644 | CA |
Y | 207W00000X | Ophthalmologist | A96644 | CA |
NPI | 1497827745 |
---|---|
Provider Name | Sudhakar V Cherukuri |
First Address | Santa Clara, CA 95128-2648 |
Second Address | Santa Clara, CA 95128-2648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 18/06/2010 |