Individual
FAYYAZ SUTTERWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 423-2948
(310) 967-1773
Mailing address
PO BOX 512717, LOS ANGELES, CA 90051-0717
(310) 967-1884
(310) 967-1773
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
042792
CT
207R00000X
Internal Medicine Physician
37567
IA
207RI0200X
Infectious Disease Physician
37567
IA
207RI0200X
Infectious Disease Physician
Primary
C143045
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71372
WELLMARK BCBS
IA
Enumeration date
10/18/2006
Last updated
10/19/2016
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