DR. ETTAYAPURUM V SUNDERRAJAN M.D. NPI 1679511315

NPI Information

NPI: 1679511315
Provider Name: DR. ETTAYAPURUM V SUNDERRAJAN, M.D.
Classification: Internal Medicine - 207RP1001X
Entity Type: Individual

Specialization: Pulmonary Disease

PECOS Registration: Yes

Address:
11180 WARNER AVE
SUITE 253
FOUNTAIN VALLEY, CA
ZIP 92708
Phone: (714) 979-2825
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DR. Ettayapurum V Sunderrajan, M.D. is a pulmonary disease internal medicine in Fountain Valley, CA with 55 years of experience. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. DR. Ettayapurum V Sunderrajan, M.D. NPI is 1679511315. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11180 WARNER AVE
SUITE 253
FOUNTAIN VALLEY, CA
ZIP 92708-501
Phone: (714) 979-2825
Fax: (714) 979-2862

The NPI 1679511315 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/3/2006 and was last updated on 4/24/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RP1001X	Internal Medicine	Pulmonary Disease	A42385	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	330387285	OTHER	CALIFORNIA	UNITED HEALTHCARE/PACIFICARE
2	330387285	OTHER	CALIFORNIA	BLUE CROSS OF CALIFORNIA
3	110022448	MEDICARE PIN	CALIFORNIA
4	W11174	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	MEDICARE GROUP NO.
5	330387825	OTHER	CALIFORNIA	AETNA
6	A85792	MEDICARE UPIN	CALIFORNIA
7	GR0053330	OTHER	CALIFORNIA	CAL-OPTIMA
8	ZZZ33736Z	OTHER	CALIFORNIA	BLUE SHIELD OF CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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