MEDICARE: MARYAM GUL 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	207RR0500X	Rheumatology Physician	A149391	CA

General Provider Information

NPI Number	:	1497015192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYAM GUL M.D.

Provider Business Mailing Address
First Line	:	2347 MANGULAR AVE
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92882-5789
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2050 S EUCLID ST
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92802-3111
Country	:	US
Telephone Number	:	714-883-7180
Fax Number	:

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

Provider Enumeration Date	:	05/29/2012
Last Update Date	:	06/29/2021

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