DR. PERAIAH SUDANAGUNTA MD NPI 1336211648

NPI Information

  • NPI: 1336211648
  • Provider Name: DR. PERAIAH SUDANAGUNTA, MD
  • Classification: General Practice - 208D00000X
  • Entity Type: Individual
  • Address: 400 WEST I ST
    LOS BANAS, CA
    ZIP 93635
  • Phone: (209) 710-6331

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NPI Details

DR. Peraiah Sudanagunta, MD is a general practice in Los Banas, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Peraiah Sudanagunta, MD NPI is 1336211648. 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:

400 WEST I ST
LOS BANAS, CA
ZIP 93635
Phone: (209) 710-6331
Fax: (209) 827-8224

The enumeration date for this NPI number is 11/14/2006 and was last updated on 12/21/2007.

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
1208D00000XGeneral PracticeA24549CALIFORNIAYes

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
1A86797MEDICARE UPINCALIFORNIA
200A245490MEDICAIDCALIFORNIA
300A245491MEDICARE PINCALIFORNIA

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: 11/21/2025

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