Individual
DAVID SULAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5823 YORK BLVD, LOS ANGELES, CA 90042-2634
(323) 255-1575
(323) 254-2158
Mailing address
5823 YORK BLVD, SUITE 1, LOS ANGELES, CA 90042-2634
(323) 255-5643
(323) 254-2158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G59029
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G590290
BLUE SHIELD
CA
05
—
00G590290
—
CA
Enumeration date
05/24/2006
Last updated
10/18/2007
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