Individual
DR. SUNIL KUMAR HEGDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
630 S. RAYMOND AVE., SUITE #120, PASADENA, CA 91105
(626) 403-1444
(626) 403-1448
Mailing address
630 S. RAYMOND AVE., SUITE #120, PASADENA, CA 91105
(626) 403-1444
(626) 403-1448
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A45472
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A454720
—
CA
01
—
A45472
BLUE CROSS OF CALIFORNIA
CA
Enumeration date
06/14/2005
Last updated
10/11/2007
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