Provider Demographics
NPI:1427313345
Name:EADULA, SEKHAR UJWALA (MD)
Entity type:Individual
Prefix:
First Name:SEKHAR UJWALA
Middle Name:
Last Name:EADULA
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 1:200 JOSE FIGUERES AVE STE 285
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1590
Mailing Address - Country:US
Mailing Address - Phone:408-438-3800
Mailing Address - Fax:
Practice Address - Street 1:200 JOSE FIGUERES AVE STE 285
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1590
Practice Address - Country:US
Practice Address - Phone:408-498-4567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA121680207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGX3782Medicare PIN