Healthcare Provider Details

I. General information

NPI: 1093873788
Provider Name (Legal Business Name): GHANSHYAM LOHIYA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 W WARNER AV #A
SANTA ANA CA
92707
US

IV. Provider business mailing address

1120 W WARNER AV #A
SANTA ANA CA
92707
US

V. Phone/Fax

Practice location:
  • Phone: 714-444-4448
  • Fax: 714-444-9892
Mailing address:
  • Phone: 714-444-4448
  • Fax: 714-444-9892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberA34243
License Number StateCA

VIII. Authorized Official

Name: GHANSHYAM LOHIYA
Title or Position: OWNER
Credential: MD
Phone: 714-444-4448