Healthcare Provider Details

I. General information

NPI: 1184650699
Provider Name (Legal Business Name): SAVITRI P. GOUD M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 01/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 EAST IMPERIAL HWY BLDG 100, ROOM 130
DOWNEY CA
90242
US

IV. Provider business mailing address

7601 EAST IMPERIAL HWY; BLDG 100, ROOM 130 RANCHO LOS AMIGOS NATIONAL REHABILITATION CTR
DOWNEY CA
90242
US

V. Phone/Fax

Practice location:
  • Phone: 562-401-7929
  • Fax: 562-218-0853
Mailing address:
  • Phone: 562-401-7929
  • Fax: 310-222-2882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA060808
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: