Provider Demographics
NPI:1093720682
Name:GODIL, ASLAM (MD)
Entity Type:Individual
Prefix:
First Name:ASLAM
Middle Name:
Last Name:GODIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SIERRA COLLEGE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5084
Mailing Address - Country:US
Mailing Address - Phone:530-273-3377
Mailing Address - Fax:530-273-3387
Practice Address - Street 1:300 SIERRA COLLEGE DR STE 105
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5084
Practice Address - Country:US
Practice Address - Phone:530-273-3377
Practice Address - Fax:530-273-3387
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG66747Medicare UPIN
CAZZZ22428ZMedicare ID - Type Unspecified