Healthcare Provider Details

I. General information

NPI: 1356374813
Provider Name (Legal Business Name): DENISE SORGET KULESHA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DENISE SORGET HOOPER MD

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 UTAH AVE STE 200
EL SEGUNDO CA
90245-4817
US

IV. Provider business mailing address

PO BOX 15638
SCOTTSDALE AZ
85267-5638
US

V. Phone/Fax

Practice location:
  • Phone: 281-766-0959
  • Fax:
Mailing address:
  • Phone: 480-728-3179
  • Fax: 480-821-3989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number35234
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number35234
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number35234
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35234
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35234
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number35234
License Number StateAZ
# 7
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number35234
License Number StateAZ
# 8
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number35234
License Number StateAZ
# 9
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME162402
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: