Provider Demographics
NPI:1952500688
Name:SONU S AHLUWALIA MD INC
Entity Type:Organization
Organization Name:SONU S AHLUWALIA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SONU
Authorized Official - Middle Name:S
Authorized Official - Last Name:AHLUWALIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-430-1310
Mailing Address - Street 1:2080 CENTURY PARK E STE 1204
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2015
Mailing Address - Country:US
Mailing Address - Phone:310-430-1310
Mailing Address - Fax:310-870-0322
Practice Address - Street 1:2080 CENTURY PARK E STE 1204
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2015
Practice Address - Country:US
Practice Address - Phone:310-430-1310
Practice Address - Fax:310-870-0322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85203207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA85203BMedicare PIN