Provider Demographics
NPI:1225234974
Name:ANWAR, GUL IRAM (MD)
Entity Type:Individual
Prefix:DR
First Name:GUL
Middle Name:IRAM
Last Name:ANWAR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1041 N CHINA LAKE BLVD
Mailing Address - Street 2:B
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-3168
Mailing Address - Country:US
Mailing Address - Phone:760-446-6404
Mailing Address - Fax:760-446-6415
Practice Address - Street 1:105 E SYDNOR AVE STE 100
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-5546
Practice Address - Country:US
Practice Address - Phone:760-446-6404
Practice Address - Fax:760-446-6415
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA109555207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACN717ZMedicare PIN
CA00A1095550Medicare PIN