Provider Demographics
NPI:1336010149
Name:HEIDI SUNGURLU DO PC
Entity type:Organization
Organization Name:HEIDI SUNGURLU DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNGURLU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:805-865-7984
Mailing Address - Street 1:1223 HIGUERA ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-3165
Mailing Address - Country:US
Mailing Address - Phone:805-864-5330
Mailing Address - Fax:805-866-7562
Practice Address - Street 1:1223 HIGUERA ST STE 203
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3165
Practice Address - Country:US
Practice Address - Phone:805-864-5330
Practice Address - Fax:805-866-7562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty