Sura Pediatric Specialist, Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A30390 Issued in CA

Legal business name

SURA PEDIATRIC SPECIALIST, INC

Doing business as

Sura Pediatric Specialist, Inc

Practice address

7400 Pacific Blvd
Suite # B
Walnut Park, CA 90255-5739

Phone

(323) 584-8881

Fax

(323) 584-8882

NPI assigned

Jul 21, 2011

Last updated

Jul 21, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

MULTI-CULTURAL MEDICAL CENTER, INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Anjana S Sura, M.D.

Title

Director

Phone

(323) 584-8881

Specialties & licenses 1

Addresses

Other names 1

• SURA PEDIATRIC SPECIALIST, INC Doing business as

Part of

Multi-Cultural Medical Center Inc

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311206400000",
    "number": "1578851747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 WALNUT PARK",
            "address_2": "SUITE # B",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902555739",
            "telephone_number": "323-584-8881",
            "fax_number": "323-584-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 PACIFIC BLVD",
            "address_2": "SUITE # B",
            "city": "WALNUT PARK",
            "state": "CA",
            "postal_code": "902555739",
            "telephone_number": "323-584-8881",
            "fax_number": "323-584-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURA PEDIATRIC SPECIALIST, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MULTI-CULTURAL MEDICAL CENTER, INC",
        "enumeration_date": "2011-07-21",
        "last_updated": "2011-07-21",
        "status": "A",
        "authorized_official_last_name": "SURA",
        "authorized_official_first_name": "ANJANA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "323-584-8881",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A30390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SURA PEDIATRIC SPECIALIST, INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Walnut Park, CA
• Providers in Walnut Park, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.