Healthcare Provider Details

I. General information

NPI: 1760181598
Provider Name (Legal Business Name): NARENDRA G GURBANI M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31862 COAST HWY STE 400
LAGUNA BEACH CA
92651-6788
US

IV. Provider business mailing address

31862 COAST HWY STE 400
LAGUNA BEACH CA
92651-6788
US

V. Phone/Fax

Practice location:
  • Phone: 949-499-8226
  • Fax:
Mailing address:
  • Phone: 949-499-8226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROCKY VALENTINE
Title or Position: BILLING & CREDENTIALING SPECIALIST
Credential:
Phone: 855-419-5678