Provider Demographics
NPI:1255695680
Name:SUNDERA V. ARIATHURAI, M.D.
Entity type:Organization
Organization Name:SUNDERA V. ARIATHURAI, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SUNDERA
Authorized Official - Middle Name:V
Authorized Official - Last Name:ARIATHURAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-500-5885
Mailing Address - Street 1:720 E COLORADO ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1712
Mailing Address - Country:US
Mailing Address - Phone:818-500-5085
Mailing Address - Fax:
Practice Address - Street 1:720 E COLORADO ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1712
Practice Address - Country:US
Practice Address - Phone:818-500-5885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-29
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty