Individual
SHYAMASUNDAR BALASUBRAMANYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10833 LE CONTE AVE STE 62-246, LOS ANGELES, CA 90095-1676
(310) 825-9820
(310) 794-6824
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
A122208
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
A122208
CA
Other
Enumeration date
11/13/2008
Last updated
11/12/2019
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