MEDICARE: DR. NAVJYOT GUJRAL M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	A60836	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174591994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAVJYOT GUJRAL M.D

Provider Business Mailing Address
First Line	:	655 CAMINO DE LOS MARES
Second Line	:	123
City	:	SAN CLEMENTE
State	:	CA
Zip	:	92673-2809
Country	:	US
Telephone Number	:	949-443-1546
Fax Number	:	949-443-1077

Provider Business Practice Location Address
First Line	:	655 CAMINO DE LOS MARES
Second Line	:	123
City	:	SAN CLEMENTE
State	:	CA
Zip	:	92673-2809
Country	:	US
Telephone Number	:	949-443-1546
Fax Number	:	949-443-1077

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	07/08/2007

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