Basic Information
| Provider Information | |||||||||
| NPI: | 1952442386 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUKHERJEE | ||||||||
| FirstName: | KAUSHIK | ||||||||
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| Credential: | MD MSCI | ||||||||
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| Mailing Information | |||||||||
| Address1: | FILE NUMBER 54701 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900744701 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 11370 ANDERSON ST STE 2100 | ||||||||
| Address2: | |||||||||
| City: | LOMA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923543450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095582822 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2007 | ||||||||
| LastUpdateDate: | 11/07/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | A135788 | CA | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | A135788 | CA | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | A135788 | CA | Y | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery |
No ID Information.