Individual
SWAMINATHA V GURUDEVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 AMSTERDAM AVE, NEW YORK, NY 10025-1716
(212) 523-2400
Mailing address
16229 DORILEE LN, ENCINO, CA 91436-4201
(619) 733-9131
(818) 545-7606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A70212
CA
207RC0000X
Cardiovascular Disease Physician
Primary
317145
NY
207RC0000X
Cardiovascular Disease Physician
A70212
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A702120
—
CA
01
—
A70212
CA MEDICAL BOARD
CA
Enumeration date
10/02/2006
Last updated
03/07/2023
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