Provider Demographics
NPI:1487820577
Name:GEULA, NAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:NAVID
Middle Name:
Last Name:GEULA
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 1:26991 CROWN VALLEY PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6511
Mailing Address - Country:US
Mailing Address - Phone:949-582-5430
Mailing Address - Fax:949-348-9513
Practice Address - Street 1:26991 CROWN VALLEY PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6511
Practice Address - Country:US
Practice Address - Phone:949-582-5430
Practice Address - Fax:949-348-9513
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A 10333207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0020A103330Medicaid
CAFG0806630OtherDEA
CACD421ZMedicare PIN