Provider Demographics
NPI:1427851385
Name:DUDEJA, KUNAL
Entity type:Individual
Prefix:
First Name:KUNAL
Middle Name:
Last Name:DUDEJA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18631 VANTAGE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-5147
Mailing Address - Country:US
Mailing Address - Phone:909-525-8290
Mailing Address - Fax:
Practice Address - Street 1:18631 VANTAGE POINTE DR
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-5147
Practice Address - Country:US
Practice Address - Phone:909-525-8290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program