Provider Demographics
NPI:1770861767
Name:BAREH, GIHAN M (MD)
Entity Type:Individual
Prefix:
First Name:GIHAN
Middle Name:M
Last Name:BAREH
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 1:12880 11TH ST
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-2033
Mailing Address - Country:US
Mailing Address - Phone:440-212-3625
Mailing Address - Fax:
Practice Address - Street 1:11175 CAMPUS STREET, COLEMAN PAVILION #11105
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3901
Practice Address - Country:US
Practice Address - Phone:909-651-5951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0543207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB151103Medicare PIN