Individual
SUNIL KALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2779 W HORIZON RIDGE PKWY, SUITE #240, HENDERSON, NV 89052-4184
(702) 240-6482
(702) 240-8529
Mailing address
700 E SILVERADO RANCH BLVD, SUITE #170, LAS VEGAS, NV 89183-7516
(702) 240-6482
(702) 240-8529
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
9939
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-0562668
TAX ID#
NV
01
—
V102532
RETIRED RAILROAD MEDICARE PIN
—
01
—
V103055
MEDICARE GROUP PTAN
NV
Enumeration date
05/16/2006
Last updated
01/12/2015
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