Provider Demographics
NPI:1811101702
Name:CHEST AND CRITICAL CARE CONSULTANTS
Entity type:Organization
Organization Name:CHEST AND CRITICAL CARE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARMOHINDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOGIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-772-8282
Mailing Address - Street 1:PO BOX 15090
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92803-5090
Mailing Address - Country:US
Mailing Address - Phone:714-772-8282
Mailing Address - Fax:714-772-6493
Practice Address - Street 1:5451 LA PALMA AVE
Practice Address - Street 2:SUITE 43
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-1728
Practice Address - Country:US
Practice Address - Phone:714-772-8282
Practice Address - Fax:714-772-6493
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHEST AND CRITICAL CARE CONSULTANTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-09
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACR0969OtherMEDICARE RR
CAGR0025656Medicaid
CAGR0025656Medicaid