Provider Demographics
NPI:1477624211
Name:GULAYA, SUNIL (MD)
Entity Type:Individual
Prefix:
First Name:SUNIL
Middle Name:
Last Name:GULAYA
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:PO BOX 544
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92822-0544
Mailing Address - Country:US
Mailing Address - Phone:714-672-9338
Mailing Address - Fax:714-255-1440
Practice Address - Street 1:1654 E 4TH ST
Practice Address - Street 2:SUITE # A
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-8300
Practice Address - Country:US
Practice Address - Phone:714-973-6333
Practice Address - Fax:714-973-2290
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA378092084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA37809Medicare ID - Type Unspecified