Provider Demographics
NPI:1134243439
Name:KAKARLA, SUDHIR P (MD)
Entity type:Individual
Prefix:DR
First Name:SUDHIR
Middle Name:P
Last Name:KAKARLA
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 1:2828 H ST
Mailing Address - Street 2:STE F
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1900
Mailing Address - Country:US
Mailing Address - Phone:661-325-2015
Mailing Address - Fax:661-325-2030
Practice Address - Street 1:4550 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7012
Practice Address - Country:US
Practice Address - Phone:661-336-0920
Practice Address - Fax:661-377-0781
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79473207RG0300X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A794730Medicaid
P00060101OtherRR RETIREMENT
601555900OtherOWCP
NV100503827Medicaid
CAZZZ26342ZMedicare ID - Type Unspecified
601555900OtherOWCP