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General NPI Number Information
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NPI Number | 1831511229
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Entity Type | Organization
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Legal Business Name | SWAMINATHA V GURUDEVAN, MD, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/20/2014
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 8635 W 3RD ST SUITE 1050W
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City | LOS ANGELES
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State | CA
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Zip | 90048-6101
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Country | US
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Telephone | 310-956-4710
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Fax | 310-997-0398
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Provider Business Mailing Address
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Address Line | 8635 W 3RD ST SUITE 1050W
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City | LOS ANGELES
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State | CA
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Zip | 90048-6101
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Country | US
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Telephone | 310-956-4710
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Fax | 310-997-0398
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SWAMINATHA V GURUDEVAN
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Credential | M.D.
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Telephone | 310-956-4710
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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 | A70212
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License Number State | CA
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