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General NPI Number Information
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NPI Number | 1932304342
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Entity Type | Individual
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Provider Name | SUJANA S GUNTA M.B., B.S.
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Gender | Female
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 818 PIER VIEW WAY
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City | OCEANSIDE
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State | CA
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Zip | 92054-2803
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Country | US
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Telephone | 760-631-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 VALE TERRACE DR
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City | VISTA
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State | CA
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Zip | 92084-5218
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Country | US
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Telephone | 760-631-5000
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A109056
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2080P0210X
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Taxonomy Name | Pediatric Nephrology Physician
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License Number | A109056
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License Number State | CA
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