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General NPI Number Information
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NPI Number | 1598966186
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Entity Type | Individual
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Provider Name | ILIA GUR M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 1225 E LATHAM AVE STE A
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City | HEMET
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State | CA
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Zip | 92543-4423
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Country | US
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Telephone | 519-766-0374
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Fax | 951-766-0601
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Provider Business Mailing Address
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Address Line | 1225 E LATHAM AVE STE A
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City | HEMET
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State | CA
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Zip | 92543-4423
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Country | US
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Telephone | 951-766-0374
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Fax | 951-766-0601
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | TRN11197
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A107317
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License Number State | CA
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