Provider Demographics
NPI:1285732727
Name:SURTI, KAVITA (MD)
Entity type:Individual
Prefix:DR
First Name:KAVITA
Middle Name:
Last Name:SURTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:420 E 3RD ST
Mailing Address - Street 2:STE 603
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-1645
Mailing Address - Country:US
Mailing Address - Phone:213-625-2694
Mailing Address - Fax:213-224-6663
Practice Address - Street 1:475 WEST BADILLO STREET
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1902
Practice Address - Country:US
Practice Address - Phone:626-732-2200
Practice Address - Fax:626-732-2900
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA83552207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH94996Medicare UPIN