Healthcare Provider Details

I. General information

NPI: 1013306638
Provider Name (Legal Business Name): PERI OZKUM GUNAY MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2015
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 BAKER ST STE 103
COSTA MESA CA
92626-4105
US

IV. Provider business mailing address

PO BOX 2153
SUISUN CITY CA
94585-5153
US

V. Phone/Fax

Practice location:
  • Phone: 714-668-2525
  • Fax: 714-668-2530
Mailing address:
  • Phone: 657-241-3600
  • Fax: 657-241-7708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PERI GUNAY
Title or Position: OWNER
Credential: MD
Phone: 714-668-2525