Individual
DR. BALA VENUGOPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11480 BROOKSHIRE AVE, SUITE 204, DOWNEY, CA 90241-5026
(562) 862-2775
(562) 904-8035
Mailing address
75 REMITTANCE DR, DEPT 6008, CHICAGO, IL 60675-6008
(562) 282-1419
(562) 920-4642
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A67362
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A673620
—
CA
Enumeration date
05/15/2006
Last updated
03/07/2023
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