Provider Demographics
NPI:1417337973
Name:THAKRAL, GAURAV (MD)
Entity Type:Individual
Prefix:
First Name:GAURAV
Middle Name:
Last Name:THAKRAL
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 1:651 ILALO ST
Mailing Address - Street 2:MEB #411E
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5525
Mailing Address - Country:US
Mailing Address - Phone:808-692-1131
Mailing Address - Fax:
Practice Address - Street 1:651 ILALO ST
Practice Address - Street 2:MEB #411E
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-5525
Practice Address - Country:US
Practice Address - Phone:808-692-1131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-31
Last Update Date:2015-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program