Provider Demographics
NPI:1558790055
Name:FRANK GAVINI MD
Entity Type:Organization
Organization Name:FRANK GAVINI MD
Other - Org Name:FRANK GAVINI MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVINI
Authorized Official - Suffix:
Authorized Official - Credentials:M,D
Authorized Official - Phone:559-772-8503
Mailing Address - Street 1:880 W 7TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-4926
Mailing Address - Country:US
Mailing Address - Phone:559-772-8503
Mailing Address - Fax:
Practice Address - Street 1:880 W 7TH ST STE 105
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4926
Practice Address - Country:US
Practice Address - Phone:559-772-8503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA044523Medicare PIN