Sundaram Family Medical Clinic Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A67659 Issued in CA

Legal business name

SUNDARAM FAMILY MEDICAL CLINIC INC.

Practice address

9217 Whittier Blvd
Pico Rivera, CA 90660-2450

Phone

(562) 699-5888

Fax

(562) 699-2955

NPI assigned

Sep 30, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Jawahar Sundaram, M.D

Title

Owner

Phone

(562) 699-5888

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• SUNDARAM FAMILY MEDICAL CLINIC Doing business as

Tax ID family

Sundaram Family Medical Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sundaram Family Medical Clinic Inc.

  • Family Medicine Physician
  • Huntington Park, CA
  • NPI 1053691766
  NPD tax ID

Locations

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

{
    "created_epoch": "1254268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308182400000",
    "number": "1992039473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9217 WHITTIER BLVD",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602450",
            "telephone_number": "562-699-5888",
            "fax_number": "562-699-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9217 WHITTIER BLVD",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906602450",
            "telephone_number": "562-699-5888",
            "fax_number": "562-699-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDARAM FAMILY MEDICAL CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-30",
        "last_updated": "2011-06-16",
        "status": "A",
        "authorized_official_last_name": "SUNDARAM",
        "authorized_official_first_name": "JAWAHAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-699-5888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A67659",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A92178",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA15565",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA19004",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA21327",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA21547",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20A7566",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUNDARAM FAMILY MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Pico Rivera, CA
• Providers in Pico Rivera, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.

Verify at the official NPI Registry.