Provider Demographics
NPI:1619107083
Name:GEVORGYAN, GOHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:GOHAR
Middle Name:
Last Name:GEVORGYAN
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:PO BOX 6578
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93386-6578
Mailing Address - Country:US
Mailing Address - Phone:661-872-3311
Mailing Address - Fax:661-872-3366
Practice Address - Street 1:3535 SAN DIMAS ST STE 14
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1694
Practice Address - Country:US
Practice Address - Phone:661-522-0043
Practice Address - Fax:661-871-1413
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA106174207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1619107083OtherKFHC