Provider Demographics
NPI:1114942059
Name:GOKLI, ASIT R (MD)
Entity Type:Individual
Prefix:DR
First Name:ASIT
Middle Name:R
Last Name:GOKLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1200 SCENIC DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-6167
Mailing Address - Country:US
Mailing Address - Phone:209-236-0676
Mailing Address - Fax:209-236-0682
Practice Address - Street 1:1200 SCENIC DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-6167
Practice Address - Country:US
Practice Address - Phone:209-236-0676
Practice Address - Fax:209-236-0682
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC54214207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4199357Medicaid
MIF01784Medicare UPIN
MI4199357Medicaid