Organization
SURINDRA N. MITRUKA, M.D. A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE DEGHETALDI (CEO/MD)
(831) 458-5695
Entity
Organization
Contact information
Practice address
1575 SOQUEL DR, SUITE #C, SANTA CRUZ, CA 95065-1709
(831) 458-6288
(831) 477-9026
Mailing address
2025 SOQUEL AVE, SANTA CRUZ, CA 95062-1323
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G84058
CA
Other
Enumeration date
07/01/2011
Last updated
02/13/2012
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