Provider Demographics
NPI:1215165600
Name:SETHI, SAURABH (MD)
Entity type:Individual
Prefix:
First Name:SAURABH
Middle Name:
Last Name:SETHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 MOWRY AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1626
Mailing Address - Country:US
Mailing Address - Phone:510-796-0222
Mailing Address - Fax:510-796-7760
Practice Address - Street 1:2333 MOWRY AVE STE 200
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1626
Practice Address - Country:US
Practice Address - Phone:510-796-3400
Practice Address - Fax:510-796-6306
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-24
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA128757207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA46645Medicaid