NPI Code Details Logo

NPI 1356374813

NPI 1356374813 : DENISE SORGET KULESHA MD : EL SEGUNDO, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1356374813
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    DENISE SORGET KULESHA MD
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/08/2006
-----------------------------------------------------
    Last Update Date     |    01/09/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2330 UTAH AVE STE 200 
-----------------------------------------------------
    City                 |    EL SEGUNDO
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    90245-4817
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    281-766-0959
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 15638 
-----------------------------------------------------
    City                 |    SCOTTSDALE
-----------------------------------------------------
    State                |    AZ
-----------------------------------------------------
    Zip                  |    85267-5638
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    480-728-3179
-----------------------------------------------------
    Fax                  |    480-821-3989
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    2085B0100X
-----------------------------------------------------
    Taxonomy Name        |    Body Imaging Physician
-----------------------------------------------------
    License Number       |    35234
-----------------------------------------------------
    License Number State |    AZ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    2085N0904X
-----------------------------------------------------
    Taxonomy Name        |    Nuclear Radiology Physician
-----------------------------------------------------
    License Number       |    35234
-----------------------------------------------------
    License Number State |    AZ
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    2085P0229X
-----------------------------------------------------
    Taxonomy Name        |    Pediatric Radiology Physician
-----------------------------------------------------
    License Number       |    35234
-----------------------------------------------------
    License Number State |    AZ
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    2085R0001X
-----------------------------------------------------
    Taxonomy Name        |    Radiation Oncology Physician
-----------------------------------------------------
    License Number       |    35234
-----------------------------------------------------
    License Number State |    AZ
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
    Taxonomy Code        |    2085R0202X
-----------------------------------------------------
    Taxonomy Name        |    Diagnostic Radiology Physician
-----------------------------------------------------
    License Number       |    35234
-----------------------------------------------------
    License Number State |    AZ
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
    Taxonomy Code        |    2085R0203X
-----------------------------------------------------
    Taxonomy Name        |    Therapeutic Radiology Physician
-----------------------------------------------------
    License Number       |    35234
-----------------------------------------------------
    License Number State |    AZ
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
    Taxonomy Code        |    2085R0204X
-----------------------------------------------------
    Taxonomy Name        |    Vascular & Interventional Radiology Physician
-----------------------------------------------------
    License Number       |    35234
-----------------------------------------------------
    License Number State |    AZ
-----------------------------------------------------
Taxonomy #8
-----------------------------------------------------
    Taxonomy Code        |    2085U0001X
-----------------------------------------------------
    Taxonomy Name        |    Diagnostic Ultrasound Physician
-----------------------------------------------------
    License Number       |    35234
-----------------------------------------------------
    License Number State |    AZ
-----------------------------------------------------
Taxonomy #9
-----------------------------------------------------
    Taxonomy Code        |    2085R0202X
-----------------------------------------------------
    Taxonomy Name        |    Diagnostic Radiology Physician
-----------------------------------------------------
    License Number       |    ME162402
-----------------------------------------------------
    License Number State |    FL
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.