Provider Demographics
NPI:1881139988
Name:NEHAL GHEVARIYA MD, PC
Entity type:Organization
Organization Name:NEHAL GHEVARIYA MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GHEVARIYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-357-8180
Mailing Address - Street 1:15035 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-1901
Mailing Address - Country:US
Mailing Address - Phone:510-357-8180
Mailing Address - Fax:510-357-0276
Practice Address - Street 1:15035 E 14TH ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-1901
Practice Address - Country:US
Practice Address - Phone:510-357-8180
Practice Address - Fax:510-357-0276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-28
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123797207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty