Made Sutjita
Infectious Disease
26520 Cactus Ave
Moreno Valley
, California 92555-3927
Made Sutjita
Infectious Disease
26520 Cactus Ave
Moreno Valley
, California 92555-3927
(951) 656-1510
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About
Features
Specialties
- Infectious Disease
Languages spoken
- English
Location
First Address
- Made Sutjita
- Po Box 7270
- Moreno Valley, CA
- Zip : 92552-7270
- Fax : (951) 656-1510
- Phone : (951) 656-1500
Second Address
- Made Sutjita
- 26520 Cactus Ave
- Moreno Valley, CA
- Zip : 92555-3927
- Fax : (951) 486-5705
- Phone : (951) 486-5700
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FAQs
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Is Made Sutjita a sole practitioner?
Is Made Sutjita accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RI0200X | Infectious Disease | A77694 | CA |
National Provider Identifier
| NPI | 1053428334 |
|---|---|
| Provider Name | Made Sutjita |
| First Address | Moreno Valley, CA 92552-7270 |
| Second Address | Moreno Valley, CA 92555-3927 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/08/2006 |
| Last Update Date | 13/06/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| G98429 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.