Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.061845 | OH |
N | 2080N0001X | Neonatal-Perinatal Doctor | 35.061845 | OH |
Y | 2080N0001X | Neonatal-Perinatal Doctor | C149272 | CA |
NPI | 1124050844 |
---|---|
Provider Name | Suhas G Kallapur |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-3026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 17/03/2018 |