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General NPI Number Information
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NPI Number | 1407924996
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Entity Type | Organization
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Legal Business Name | SURENDER VUTHOORI MD INC
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 05/18/2009
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Provider Practice Location Address
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Address Line | 35280 BOB HOPE DR STE 100
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270
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Country | US
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Telephone | 760-770-1632
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Fax | 760-346-2471
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Provider Business Mailing Address
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Address Line | 35280 BOB HOPE DR STE 100
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270
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Country | US
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Telephone | 760-770-1632
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Fax | 760-346-2471
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SURENDER VUTHOORI
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Credential | MD
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Telephone | 760-770-1632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A33804
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License Number State | CA
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