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) 770-1632
Entity
Organization
Contact information
Practice address
35280 BOB HOPE DR, STE 100, RANCHO MIRAGE, CA 92270
(760) 770-1632
(760) 346-2471
Mailing address
35280 BOB HOPE DR, STE 100, RANCHO MIRAGE, CA 92270
(760) 770-1632
(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
01
—
00A338040
BLUESHIELD
CA
05
—
00A338041
—
CA
01
—
199003100
ACSTA ACS DEPARTMENT OF LABOUR
CA
01
—
756061629
MEDICARE RAIL ROAD
CA
01
—
913622300
MED FL MEDI CAL FLORIDA
CA
01
—
ZZZ91620Z
MEDICARE ID TYPE
CA
Enumeration date
12/01/2006
Last updated
05/18/2009
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