Provider Demographics
NPI:1558411322
Name:GOGNA, HARJIT RITA (MD)
Entity Type:Individual
Prefix:DR
First Name:HARJIT
Middle Name:RITA
Last Name:GOGNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7417 SPY GLASS DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9578
Mailing Address - Country:US
Mailing Address - Phone:209-985-7705
Mailing Address - Fax:209-544-3402
Practice Address - Street 1:1401 SPANOS CT
Practice Address - Street 2:207
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2810
Practice Address - Country:US
Practice Address - Phone:209-544-3400
Practice Address - Fax:209-544-3402
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA042698207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine