Provider Demographics
NPI:1679588180
Name:CHUGH, SUMEET S (MD)
Entity type:Individual
Prefix:
First Name:SUMEET
Middle Name:S
Last Name:CHUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 512717
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-0717
Mailing Address - Country:US
Mailing Address - Phone:310-423-3300
Mailing Address - Fax:310-423-2522
Practice Address - Street 1:127, SAN VICENTE BLVD SOUTH
Practice Address - Street 2:SUITE A3100
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-1860
Practice Address - Country:US
Practice Address - Phone:310-423-3300
Practice Address - Fax:310-423-3522
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC53535207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR134156Medicaid
OR134156Medicaid