Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | A313120 | CA |
N | 208000000X | Pediatrician | A313120 | CA |
NPI | 1316032907 |
---|---|
Provider Name | Seturam Pandurangi |
First Address | Fairfield, CA 94533-3551 |
Second Address | Fairfield, CA 94533-3551 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A26433 | (02) | CA |
A313120 | (05) | CA |