Active NPI
Mythili Sundaresan, MD
- Neurology Physician
- Visalia, CA
National Provider Identifier
1841278983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- A403750
- Practice address
- 231 W Noble Ave
Visalia, CA 93277-2631 - Phone
- (559) 635-7100
- Fax
- (559) 635-7104
- NPI assigned
- Jan 9, 2006
- Last updated
- May 6, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | A403750 | CA | Primary |
Addresses
Primary practice location
231 W Noble Ave
Visalia, CA 93277-2631
Mailing address
PO Box 1514
Tulare, CA 93275
Phone (559) 635-7100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A403750 | Medicaid | CA |
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 |
|---|---|---|---|
| A403750 | CA | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304640000000",
"number": "1841278983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1514",
"city": "TULARE",
"state": "CA",
"postal_code": "93275",
"telephone_number": "559-635-7100",
"fax_number": "559-635-7104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "231 W NOBLE AVE",
"city": "VISALIA",
"state": "CA",
"postal_code": "932772631",
"telephone_number": "559-635-7100",
"fax_number": "559-635-7104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUNDARESAN",
"first_name": "MYTHILI",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-09",
"last_updated": "2011-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "CA",
"license": "A403750",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A403750",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Visalia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.