Healthcare Provider Details

I. General information

NPI: 1821135310
Provider Name (Legal Business Name): NINA I GARGA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST SFVAMC, EPILEPSY CENTER OF EXCELLENCE, BOX 127E
SAN FRANCISCO CA
94121-1545
US

IV. Provider business mailing address

4150 CLEMENT ST, BOX 127E
SAN FRANCISCO CA
94121-1545
US

V. Phone/Fax

Practice location:
  • Phone: 415-379-5599
  • Fax: 415-379-5666
Mailing address:
  • Phone: 415-221-4810
  • Fax: 415-379-5666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberA86347
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberA86347
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA86347
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: