Provider Demographics
NPI:1225107006
Name:GU, DAVID (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 S GARFIELD AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4429
Mailing Address - Country:US
Mailing Address - Phone:626-282-3999
Mailing Address - Fax:626-282-8077
Practice Address - Street 1:723 S GARFIELD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4429
Practice Address - Country:US
Practice Address - Phone:626-282-3999
Practice Address - Fax:626-282-8077
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6851207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX68510Medicaid
CAW20A6851CMedicare ID - Type Unspecified
CA00AX68510Medicaid