Healthcare Provider Details

I. General information

NPI: 1659450054
Provider Name (Legal Business Name): CHEST AND CRITICAL CARE CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2006
Last Update Date: 05/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13522 NEWPORT AVE SUITE 102
TUSTIN CA
92780-3707
US

IV. Provider business mailing address

13522 NEWPORT AVE SUITE 19
TUSTIN CA
92780-3707
US

V. Phone/Fax

Practice location:
  • Phone: 714-491-1159
  • Fax: 714-491-8931
Mailing address:
  • Phone: 714-491-1159
  • Fax: 714-491-8931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HARMOHINDER S GOGIA
Title or Position: SENIOR MANAGING PARTNER
Credential: M.D.
Phone: 714-772-8282