Provider Demographics
NPI:1447609342
Name:HANS, GURKAMAL
Entity Type:Individual
Prefix:
First Name:GURKAMAL
Middle Name:
Last Name:HANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ROWLAND WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-5054
Mailing Address - Country:US
Mailing Address - Phone:415-897-3174
Mailing Address - Fax:415-892-9589
Practice Address - Street 1:75 ROWLAND WAY STE 200
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-5054
Practice Address - Country:US
Practice Address - Phone:415-897-3174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA162202207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine