Individual
PURUSHOTHAM KOTHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8860 CENTER DR, #400, LA MESA, CA 91942-3068
(619) 229-1995
Mailing address
8860 CENTER DR, #400, LA MESA, CA 91942-3068
(619) 229-1995
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A41538
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0099230
—
CA
Enumeration date
07/13/2006
Last updated
09/19/2012
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