Provider Demographics
NPI:1003964370
Name:CARE GASTROENTEROLOGY MEDICAL GROUP
Entity Type:Organization
Organization Name:CARE GASTROENTEROLOGY MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NAVJYOT
Authorized Official - Middle Name:
Authorized Official - Last Name:GUJRAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-734-4396
Mailing Address - Street 1:PO BOX 4517
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92690-4517
Mailing Address - Country:US
Mailing Address - Phone:949-443-1546
Mailing Address - Fax:949-443-1077
Practice Address - Street 1:655 CAMINO DE LOS MARES
Practice Address - Street 2:SUTE 123
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-2809
Practice Address - Country:US
Practice Address - Phone:949-443-1546
Practice Address - Fax:949-443-1077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60836207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A608360Medicaid
CAG35404Medicare UPIN
CAA60836Medicare ID - Type UnspecifiedNAVJYOT GUJRAL, M.D.