| Sudha Govindarrajan Md A Professional Corp | |
|
101 E Beverly Blvd Ste 302 Montebello CA 90640-4316 | |
| (323) 728-8181 | |
| (323) 724-9725 |
| Full Name | Sudha Govindarrajan Md A Professional Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 101 E Beverly Blvd Ste 302, Montebello, California |
| Authorized Official Name and Position | Sudha Govindarajan (PRESIDENT) |
| Authorized Official Contact | 3237288181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sudha Govindarrajan Md A Professional Corp 101 E Beverly Blvd Ste 302 Montebello CA 90640-4316 Ph: (323) 728-8181 | Sudha Govindarrajan Md A Professional Corp 101 E Beverly Blvd Ste 302 Montebello CA 90640-4316 Ph: (323) 728-8181 |
| NPI Number | 1083835995 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 09/30/2014 |
| Medicare PECOS PAC ID | 0749342103 |
|---|---|
| Medicare Enrollment ID | O20081218000229 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083835995 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sudha Govindarajan |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1184612061 PECOS PAC ID: 1557439890 Enrollment ID: I20081014000184 |
| Provider Name | Sudha Govindarajan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184612061 PECOS PAC ID: 1557439890 Enrollment ID: I20150328000069 |
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