Provider Demographics
NPI:1730493107
Name:PIYUSH K, JOGANI, MD
Entity Type:Organization
Organization Name:PIYUSH K, JOGANI, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD.
Authorized Official - Prefix:
Authorized Official - First Name:PIYUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOGANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:818-885-9200
Mailing Address - Street 1:PO BOX 280204
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91328-0204
Mailing Address - Country:US
Mailing Address - Phone:818-885-9200
Mailing Address - Fax:818-885-9201
Practice Address - Street 1:18250 ROSCOE BLVD
Practice Address - Street 2:SUITE #310
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4226
Practice Address - Country:US
Practice Address - Phone:818-885-9200
Practice Address - Fax:818-885-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39138207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA60613Medicare UPIN