Provider Demographics
NPI:1164642773
Name:NARAYAN, GUJARATHI L (MD)
Entity Type:Individual
Prefix:
First Name:GUJARATHI
Middle Name:L
Last Name:NARAYAN
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 1:468 N VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-1631
Mailing Address - Country:US
Mailing Address - Phone:559-591-6200
Mailing Address - Fax:559-591-2724
Practice Address - Street 1:468 N VERMONT AVE
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-1631
Practice Address - Country:US
Practice Address - Phone:559-591-6200
Practice Address - Fax:559-591-2724
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38401207V00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHAP53949FMedicaid
CARHM53949FMedicaid
CA00A384010Medicaid
CA00A384010Medicaid
CARHM53949FMedicaid