Provider Demographics
NPI:1861915118
Name:MADHU, SUNEETHA (MD)
Entity type:Individual
Prefix:
First Name:SUNEETHA
Middle Name:
Last Name:MADHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 POWELL ST STE 400
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1872
Mailing Address - Country:US
Mailing Address - Phone:510-851-7501
Mailing Address - Fax:
Practice Address - Street 1:2100 POWELL ST STE 400
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1872
Practice Address - Country:US
Practice Address - Phone:510-851-7501
Practice Address - Fax:510-851-7446
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-19
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA167399208M00000X
FLTRN25604207R00000X
TXV2155207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist