Healthcare Provider Details

I. General information

NPI: 1952529182
Provider Name (Legal Business Name): GREGORY N OGATA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13440 E. IMPERIAL HWY
SANTA FE SPRINGS CA
90670-4820
US

IV. Provider business mailing address

PO BOX 2867
SANTA FE SPRINGS CA
90670-0867
US

V. Phone/Fax

Practice location:
  • Phone: 562-926-3440
  • Fax: 562-926-0592
Mailing address:
  • Phone: 562-926-3440
  • Fax: 562-926-0592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberG59713
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: