Provider Demographics
NPI:1619358272
Name:GORJI, RYAN MAJD (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:MAJD
Last Name:GORJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43322 GINGHAM AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-4577
Mailing Address - Country:US
Mailing Address - Phone:661-874-4050
Mailing Address - Fax:
Practice Address - Street 1:43322 GINGHAM AVE STE 103
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-4577
Practice Address - Country:US
Practice Address - Phone:661-874-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA165855207Q00000X
IL125071575207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine