Provider Demographics
NPI:1689607293
Name:HINIKA, GUDATA (MD)
Entity Type:Individual
Prefix:DR
First Name:GUDATA
Middle Name:
Last Name:HINIKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15944 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5008
Mailing Address - Country:US
Mailing Address - Phone:562-531-0784
Mailing Address - Fax:562-531-0786
Practice Address - Street 1:15944 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5008
Practice Address - Country:US
Practice Address - Phone:562-531-0784
Practice Address - Fax:562-531-0786
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA630292086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery