Healthcare Provider Details

I. General information

NPI: 1134532252
Provider Name (Legal Business Name): GURJIT MARWAH MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 06/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 W 7TH ST
OXNARD CA
93030-6755
US

IV. Provider business mailing address

911 W 7TH ST
OXNARD CA
93030-6755
US

V. Phone/Fax

Practice location:
  • Phone: 805-487-9492
  • Fax: 805-487-2596
Mailing address:
  • Phone: 805-487-9492
  • Fax: 805-487-2596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA50005
License Number StateCA

VIII. Authorized Official

Name: DR. GURJIT SINGH MARWAH
Title or Position: PRESIDENT
Credential: MD
Phone: 626-233-9727