Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A54475 | CA |
NPI | 1013970169 |
---|---|
Provider Name | Gurpreet Singh Ahuja |
First Address | Orange, CA 92868-4300 |
Second Address | Orange, CA 92868-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 13/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A544750 | (05) | CA |
G12975 | (02) | CA |