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General NPI Number Information
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NPI Number | 1487962353
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Entity Type | Organization
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Legal Business Name | SUKHDEV K UPPAL MD INC.
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 800 MAGNOLIA AVE SUITE 107
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City | CORONA
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State | CA
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Zip | 92879-3123
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Country | US
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Telephone | 951-372-0955
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Fax | 951-372-0918
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Provider Business Mailing Address
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Address Line | 800 MAGNOLIA AVE SUITE 107
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City | CORONA
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State | CA
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Zip | 92879-3123
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Country | US
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Telephone | 951-372-0955
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Fax | 951-372-0918
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUKHDEV KAUR UPPAL
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Credential | MD
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Telephone | 951-372-0955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A54106
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License Number State | CA
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