Provider Demographics
NPI:1578147617
Name:CALIFORNIA GASTROENTEROLOGY INSTITUTE
Entity Type:Organization
Organization Name:CALIFORNIA GASTROENTEROLOGY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SALEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-527-1747
Mailing Address - Street 1:1240 S WESTLAKE BLVD STE 137
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1988
Mailing Address - Country:US
Mailing Address - Phone:818-527-1747
Mailing Address - Fax:
Practice Address - Street 1:1240 S WESTLAKE BLVD STE 137
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-1988
Practice Address - Country:US
Practice Address - Phone:818-527-1747
Practice Address - Fax:818-476-5614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty