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General NPI Number Information
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NPI Number | 1417908161
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Entity Type | Organization
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Legal Business Name | SUNIL KALLA, M.D., INC. PC
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 3031 W HORIZON RIDGE PKWY SUITE 120
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City | HENDERSON
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State | NV
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Zip | 89052-3808
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Country | US
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Telephone | 702-433-2777
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 36830
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City | LAS VEGAS
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State | NV
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Zip | 89133-6830
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Country | US
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Telephone | 702-433-2777
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUNIL KALLA
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Credential | MD
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Telephone | 702-433-2777
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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 | 9939
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License Number State | NV
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