Individual
PREMINI SIVARUBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11333 SEPULVEDA BLVD, MISSION HILLS, CA 91345-1116
(818) 365-9531
(818) 837-5741
Mailing address
PO BOX 9602, MISSION HILLS, CA 91346-9602
(818) 837-5559
(818) 792-4793
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
A130018
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A1300180
—
CA
Enumeration date
02/05/2014
Last updated
03/14/2024
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