Individual
SHYAMSUNDER SUBRAMANIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 W EATON AVE, SUITE E, TRACY, CA 95376-3400
(209) 830-1500
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6097
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
C133248
CA
207RP1001X
Pulmonary Disease Physician
Primary
C133248
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050417
—
OH
05
—
100867463
—
PA
Enumeration date
09/16/2005
Last updated
12/15/2015
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