Individual provider · Type 1 NPI

Spoorthy Prabhudeva, MD

Student in an Organized Health Care Education/Training Program · Stockton, CA

NPI number 1679369912 Active

Practice location

1800 N California St
Stockton, CA 95204-6019

Call (209) 547-7143 Map

Other practice locations

  • 500 W Hospital Rd, French Camp, CA 95231-9693 · (209) 468-6620

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1679369912

Spoorthy Prabhudeva, MD's National Provider Identifier is 1679369912, issued on Apr 15, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Stockton, CA. The record was last updated on Mar 29, 2026.