Individual
DR. AJMEL A PUTHAWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18111 BROOKHURST ST, SUITE 0300, FOUNTAIN VALLEY, CA 92708-6728
(714) 962-7100
(714) 963-7600
Mailing address
2650 ELM AVE, SUITE 201, LONG BEACH, CA 90806-1651
(562) 492-6695
(562) 988-0389
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
A29351
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A029351
—
CA
01
—
A29351
LICENSE
CA
Enumeration date
08/06/2006
Last updated
03/07/2023
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