Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 031714 | CA |
NPI | 1144348442 |
---|---|
Provider Name | Dr. Eugene Isamu Sugita |
First Address | La Mesa, CA 91942-7001 |
Second Address | La Mesa, CA 91942-7001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 05/03/2013 |