Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 20A12250 | CA |
NPI | 1114142999 |
---|---|
Provider Name | Dr. Heidi Sungurlu |
First Address | San Luis Obispo, CA 93405-1887 |
Second Address | San Luis Obispo, CA 93405-1887 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 15/01/2015 |