Sobha Sunderrajan, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A42428 Issued in CA

Practice address

11180 Warner Ave
# 271
Fountain Valley, CA 92708-4019

Phone

(714) 435-0150

Fax

(714) 436-0126

NPI assigned

Sep 27, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gaytri Manek MD Inc

  • Nephrology Physician
  • Fountain Valley, CA
  • NPI 1912352774
  NPD

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1932195641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE",
            "address_2": "# 271",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087501",
            "telephone_number": "714-435-0150",
            "fax_number": "714-436-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE",
            "address_2": "# 271",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084019",
            "telephone_number": "714-435-0150",
            "fax_number": "714-436-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDERRAJAN",
        "first_name": "SOBHA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A42428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A48481",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derrick Weison Su, MD
• Angeli D Suarez, M.D.
• Shunmugaraja Subbiah, M.D.
• Isaac Sun, DDS
• Ettayapurum V Sunderrajan, M.D.
• Sarah Sung, PHARMD
• Sunita Moola MD Inc
• Sunrise Home Health Care LLC
• Sunshine Guest Home LLC
• Sunshine Hospice of Southern California Inc

• Specialist in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.