Provider Demographics
NPI:1245910967
Name:GOOD, GURUSAHAI
Entity type:Individual
Prefix:
First Name:GURUSAHAI
Middle Name:
Last Name:GOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GIGI
Other - Middle Name:
Other - Last Name:GOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:6093 S QUEBEC ST STE 102
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4543
Mailing Address - Country:US
Mailing Address - Phone:808-385-2278
Mailing Address - Fax:
Practice Address - Street 1:6093 S QUEBEC ST
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4542
Practice Address - Country:US
Practice Address - Phone:808-385-2278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002784171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist