Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Sourabh Suryadevara, MD

Individual provider Internal Medicine Physician · NPI 1043505969

Sourabh Suryadevara, MD is an Internal Medicine in Mission Hills, California. Qualified in 2011, 15 years ago. Practices with Providence Facey Medical Foundation, a 323-clinician group and accepts Medicare assignment. Licensed in California and Massachusetts.

Years since qualifying
15
Licensed in
CA, MA
In the registry since
2011
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

11333 Sepulveda Blvd
Mission Hills, CA 91345-1116
Phone: (818) 365-9531
Fax: (818) 837-5741
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence A131476 (CA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 249251 (MA)

Record details

NPI number1043505969
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 20, 2011
Last updated in NPPESOctober 31, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Providence Facey Medical Foundation — 323 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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