Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | A72917 | CA |
NPI | 1114955705 |
---|---|
Provider Name | Dr. Dechu Puliyanda |
First Address | Los Angeles, CA 90051-0717 |
Second Address | West Hollywood, CA 90048-1865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 21/01/2022 |