Organization
SURENDER VUTHOORI MD INC
Active
Parent organization
SURENDER VUTHOORI MD INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SURENDER VUTHOORI MD INC
Authorized official
DR. SURENDER VUTHOORI MD (PRESIDENT)
(760) 366-8491
Entity
Organization
Contact information
Practice address
63532 29 PALMS HWY, #A, JOSHUA TREE, CA 92252
(760) 366-8491
(760) 346-2471
Mailing address
PO BOX 168, 63532 29 PALMS HWY STE A, JOSHUA TREE, CA 92252
(760) 366-8491
(760) 346-2471
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A33804
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A338040
—
CA
01
—
199003100
US LAB US DEPARTMENT OF LABOUR
CA
01
—
756061629
MEDICARE RAILROAD
CA
01
—
913622300
MEDFL MEDICAL FLORIDA
CA
01
—
ZZZ89656Z
MEDICARE ID TYPE
CA
Enumeration date
08/17/2006
Last updated
05/18/2009
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