Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | A45472 | CA |
NPI | 1003811340 |
---|---|
Provider Name | Dr. Sunil Kumar Hegde |
First Address | Pasadena, CA 91105 |
Second Address | Pasadena, CA 91105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 11/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A454720 | (05) | CA |
A45472 | BLUE CROSS OF CALIFORNIA (01) | CA |
E40893 | (02) | CA |