Provider Demographics
NPI:1710237821
Name:GARCHA, GAGAN PREET (MD)
Entity Type:Individual
Prefix:
First Name:GAGAN
Middle Name:PREET
Last Name:GARCHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GAGAN
Other - Middle Name:
Other - Last Name:PREET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1700 PRAIRIE CITY RD
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-9594
Practice Address - Country:US
Practice Address - Phone:916-351-4800
Practice Address - Fax:916-351-4899
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301100668207R00000X, 390200000X
CAA163190208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program