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General NPI Number Information
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NPI Number | 1518689017
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Entity Type | Organization
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Legal Business Name | GORSI PHYSICIANS GROUP
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 467 GRAY AVE
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City | YUBA CITY
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State | CA
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Zip | 95991-4813
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Country | US
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Telephone | 312-752-5403
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Fax |
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Provider Business Mailing Address
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Address Line | 467 GRAY AVE
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City | YUBA CITY
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State | CA
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Zip | 95991-4813
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Country | US
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Telephone | 312-752-5403
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAMAILA GORSI
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Credential | MD
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Telephone | 312-752-5403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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