Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | A87655 | CA |
NPI | 1174606016 |
---|---|
Provider Name | Sunil S. Rayan |
First Address | Encinitas, CA 92024-5139 |
Second Address | Encinitas, CA 92024-5139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 20/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A896550 | (05) | CA |
I06873 | (02) |