Provider Demographics
NPI:1174591994
Name:GUJRAL, NAVJYOT (MD)
Entity type:Individual
Prefix:DR
First Name:NAVJYOT
Middle Name:
Last Name:GUJRAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 CAMINO DE LOS MARES
Mailing Address - Street 2:123
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-2809
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 2:123
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
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60836207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A608360Medicaid
CAA60836Medicare ID - Type Unspecified
CA00A608360Medicaid