Individual
MADE SUTJITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26520 CACTUS AVE, MORENO VALLEY, CA 92555-3927
(951) 486-5700
(951) 486-5705
Mailing address
PO BOX 7270, MORENO VALLEY, CA 92552-7270
(951) 656-1500
(951) 656-1510
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
A77694
CA
Other
Enumeration date
08/24/2006
Last updated
06/13/2015
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