Individual
MUKESH B. SUTHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10808 FOOTHILL BLVD, SUITE 160-203, RANCHO CUCAMONGA, CA 91730-3889
(909) 660-3003
Mailing address
10808 FOOTHILL BLVD, SUITE 160-203, RANCHO CUCAMONGA, CA 91730-3889
(909) 895-4531
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G86105
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
G86105
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G861050
—
CA
Enumeration date
01/08/2007
Last updated
08/23/2022
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