Sunder Mudaliar, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A52644 Issued in CA

Practice address

3350 La Jolla Village Dr # 111G
San Diego, CA 92161-3254

Phone

(858) 642-3152

Fax

(858) 642-6242

NPI assigned

May 9, 2006

Last updated

Sep 3, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283472000000",
    "number": "1750330346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR # 111G",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921613254",
            "telephone_number": "858-642-3152",
            "fax_number": "858-642-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR # 111G",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921613254",
            "telephone_number": "858-642-3152",
            "fax_number": "858-642-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDALIAR",
        "first_name": "SUNDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2010-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A52644",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A52644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ron Muchnick, MFT PH.D.
• Sherri Muchnick, MFT PH.D.
• Victoria Muchnik-Fox, PA
• Cherrylin Almodovar Mucho
• Maria Jose Mucino Escobedo
• Alexis Mudge
• Rathnasiri K. Mudiyanselage, D.D.S.
• Danijela Mudri-Nicin
• Lauren Elizabeth Muecke
• Jeff L Muehl, D.D.S.

• Internal Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.