Provider Demographics
NPI:1255192373
Name:SURIAKANNU, ARULKUMARAN
Entity type:Individual
Prefix:
First Name:ARULKUMARAN
Middle Name:
Last Name:SURIAKANNU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25455 PINO LN
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-4918
Mailing Address - Country:US
Mailing Address - Phone:949-243-7194
Mailing Address - Fax:
Practice Address - Street 1:25455 PINO LN
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-4918
Practice Address - Country:US
Practice Address - Phone:949-243-7194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker