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General NPI Number Information
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NPI Number | 1699726240
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Entity Type | Individual
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Provider Name | SUNIL KALLA MD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 01/12/2015
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Provider Practice Location Address
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Address Line | 2779 W HORIZON RIDGE PKWY SUITE #240
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City | HENDERSON
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State | NV
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Zip | 89052-4184
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Country | US
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Telephone | 702-240-6482
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Fax | 702-240-8529
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Provider Business Mailing Address
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Address Line | 700 E SILVERADO RANCH BLVD SUITE #170
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City | LAS VEGAS
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State | NV
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Zip | 89183-7516
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Country | US
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Telephone | 702-240-6482
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Fax | 702-240-8529
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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