Healthcare Provider Details

I. General information

NPI: 1437005865
Provider Name (Legal Business Name): GI GHEVARIYA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15035 E 14TH ST
SAN LEANDRO CA
94578-1901
US

IV. Provider business mailing address

15035 E 14TH ST
SAN LEANDRO CA
94578-1901
US

V. Phone/Fax

Practice location:
  • Phone: 341-200-1940
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: VISHAL GHEVARIYA
Title or Position: PRESIDENT
Credential:
Phone: 341-200-1940