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General NPI Number Information
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NPI Number | 1447372487
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Entity Type | Organization
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Legal Business Name | PURUSHOTHAM AND AKTHER J KOTHA M D INC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 8860 CENTER DR #400
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City | LA MESA
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State | CA
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Zip | 91942-3068
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Country | US
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Telephone | 619-229-1995
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Fax |
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Provider Business Mailing Address
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Address Line | 8860 CENTER DR #400
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City | LA MESA
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State | CA
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Zip | 91942-3068
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Country | US
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Telephone | 619-229-1995
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | MRS. AKTHER J KOTHA
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Credential | MD
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Telephone | 619-229-1995
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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 | A415338
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | A45440
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License Number State | CA
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