Active NPI
Harjit J Sud, M.D.
- Obstetrics & Gynecology Physician
- Stockton, CA
National Provider Identifier
1699740944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- A30647
- Practice address
- 1617 N California St Ste 2a
Stockton, CA 95204-6117 - Phone
- (209) 466-8546
- Fax
- (209) 466-3335
- NPI assigned
- Feb 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A30647 | CA | |
| Obstetrics & Gynecology Physician | 207V00000X | A30647 | CA | Primary |
Addresses
Primary practice location
1617 N California St Ste 2a
Stockton, CA 95204-6117
Mailing address
P.O. Box 1090
Lodi, CA 95241-1090
Phone (209) 334-1800
Other practice location 1
2509 W March Ln
Ste 250
Stockton, CA 95207-8252
Phone (209) 957-1000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A306470 | Medicaid | CA | |
| 1386636165 | Other | CA | GROUP NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A30647 | CA | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663286400000",
"number": "1699740944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 1090",
"city": "LODI",
"state": "CA",
"postal_code": "952411090",
"telephone_number": "209-334-1800",
"fax_number": "209-334-1430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1617 N CALIFORNIA ST STE 2A",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952046117",
"telephone_number": "209-466-8546",
"fax_number": "209-466-3335"
}
],
"practiceLocations": [
{
"address_1": "2509 W March Ln",
"address_2": "Ste 250",
"address_purpose": "LOCATION",
"city": "Stockton",
"state": "CA",
"postal_code": "952078252",
"country_code": "US",
"telephone_number": "209-957-1000",
"fax_number": "209-957-1001",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUD",
"first_name": "HARJIT",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-21",
"last_updated": "2022-09-16",
"certification_date": "2022-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A30647",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CA",
"license": "A30647",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A306470",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1386636165",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.