Provider Demographics
NPI:1760182737
Name:GANGSHAR, DAWA (PA-C)
Entity Type:Individual
Prefix:
First Name:DAWA
Middle Name:
Last Name:GANGSHAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:859 MULBERRY PL
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-6111
Mailing Address - Country:US
Mailing Address - Phone:510-375-6698
Mailing Address - Fax:
Practice Address - Street 1:1241 E HILLSDALE BLVD STE 190
Practice Address - Street 2:
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-1259
Practice Address - Country:US
Practice Address - Phone:650-638-1226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant