Surindra N. Mitruka, M.D. a Medical Corporation

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

G84058 Issued in CA

Legal business name

SURINDRA N. MITRUKA, M.D. A MEDICAL CORPORATION

Practice address

1575 Soquel Dr
Suite #C
Santa Cruz, CA 95065-1709

Phone

(831) 458-6288

Fax

(831) 477-9026

NPI assigned

Jul 1, 2011

Organization subpart

No

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

Authorized official

Name

Lawrence Deghetaldi

Title

Ceo/MD

Phone

(831) 458-5695

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1619264363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SOQUEL AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 SOQUEL DR",
            "address_2": "SUITE #C",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651709",
            "telephone_number": "831-458-6288",
            "fax_number": "831-477-9026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURINDRA N. MITRUKA, M.D. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-01",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "DEGHETALDI",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "CEO/MD",
        "authorized_official_telephone_number": "831-458-5695"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "G84058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Erin Sumner Ballantyne, MFT
• Micah Ece Sunata
• Sunroot MD Inc
• Mark Surber, P.T.
• Surgical Associates of Monterey Bay Medical Corporation
• James Sutherland, IMF
• Cody Sutphin, MD
• Chelsey Suttaby
• Sutter Bay Hospitals
• Sutter Bay Medical Foundation

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.