Provider Demographics
NPI:1598966186
Name:GUR, ILIA (MD)
Entity type:Individual
Prefix:
First Name:ILIA
Middle Name:
Last Name:GUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1225 E LATHAM AVE STE A
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4423
Mailing Address - Country:US
Mailing Address - Phone:951-766-0374
Mailing Address - Fax:951-766-0601
Practice Address - Street 1:1225 E LATHAM AVE STE A
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4423
Practice Address - Country:US
Practice Address - Phone:519-766-0374
Practice Address - Fax:951-766-0601
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN11197208600000X
CAA107317208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery