Sukalpa John Dutta, Md, Inc. | |
18012 Wika Rd Apple Valley CA 92307-2125 | |
(442) 292-2358 | |
(949) 404-6801 |
Full Name | Sukalpa John Dutta, Md, Inc. |
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Speciality | Family Medicine |
Location | 18012 Wika Rd, Apple Valley, California |
Authorized Official Name and Position | Sukalpa Dutta (PRESIDENT) |
Authorized Official Contact | 3104971070 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sukalpa John Dutta, Md, Inc. 18092 Wika Rd Ste 220 Apple Valley CA 92307-2132 Ph: (760) 515-6260 | Sukalpa John Dutta, Md, Inc. 18012 Wika Rd Apple Valley CA 92307-2125 Ph: (442) 292-2358 |
NPI Number | 1265123749 |
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Provider Enumeration Date | 05/16/2023 |
Last Update Date | 05/16/2023 |
Medicare PECOS PAC ID | 8224498993 |
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Medicare Enrollment ID | O20230713002463 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265123749 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Sukalpa John Dutta |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1487768586 PECOS PAC ID: 0840247698 Enrollment ID: I20050404000650 |
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