Healthcare Provider Details

I. General information

NPI: 1346637576
Provider Name (Legal Business Name): AJAY GHAI D.P.M
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2015
Last Update Date: 10/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 W HILLSDALE AVE
VISALIA CA
93291-8222
US

IV. Provider business mailing address

PO BOX 378
SANDUSKY OH
44871-0378
US

V. Phone/Fax

Practice location:
  • Phone: 559-738-7500
  • Fax: 559-734-2055
Mailing address:
  • Phone: 419-626-6161
  • Fax: 419-502-3511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36.003877
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5504
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: