Individual
SURINDRA N MITRUKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1575 SOQUEL DR, SUITE C, SANTA CRUZ, CA 95065-1700
(831) 458-6288
(831) 477-9026
Mailing address
2025 SOQUEL AVE, SANTA CRUZ, CA 95062-1323
(831) 458-6603
(831) 458-6293
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G84058
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G840580
—
CA
Enumeration date
09/20/2006
Last updated
04/27/2012
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