Healthcare Provider Details

I. General information

NPI: 1578531885
Provider Name (Legal Business Name): MURAT KAYGUSUZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2006
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 GATEWAY CENTER WAY
SAN DIEGO CA
92102-4541
US

IV. Provider business mailing address

81875 AVENUE 48 APT 82
INDIO CA
92201-6781
US

V. Phone/Fax

Practice location:
  • Phone: 619-515-2300
  • Fax: 619-906-4564
Mailing address:
  • Phone: 213-254-5890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberC52850
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC52850
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: