Healthcare Provider Details

I. General information

NPI: 1417965898
Provider Name (Legal Business Name): GIHAN G GEORGE M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W LA PALMA AVE
ANAHEIM CA
92801-2804
US

IV. Provider business mailing address

PO BOX 25033
SANTA ANA CA
92799-5033
US

V. Phone/Fax

Practice location:
  • Phone: 714-774-1450
  • Fax: 714-999-3907
Mailing address:
  • Phone: 714-347-1000
  • Fax: 714-647-1243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA88052
License Number StateCA

VIII. Authorized Official

Name: GIHAN G GEORGE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 917-715-0783