MEDICARE: EUGENE DULA MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician

General Provider Information

NPI Number	:	1588400915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EUGENE DULA MD INC

Provider Business Mailing Address
First Line	:	PO BOX 491172
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-9172
Country	:	US
Telephone Number	:	818-346-8736
Fax Number	:

Provider Business Practice Location Address
First Line	:	7345 MEDICAL CENTER DR STE 300
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-1961
Country	:	US
Telephone Number	:	818-346-8736
Fax Number	:	818-992-1640

Authorized Official
Title or Position	:	OWNER
Name	:	EUGENE DULA
Credential	:	MD
Telephone Number	:	818-346-8736

Provider Enumeration Date	:	07/04/2024
Last Update Date	:	07/04/2024

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