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General NPI Number Information
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NPI Number | 1831415579
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Entity Type | Organization
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Legal Business Name | GEKO INC
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 04/19/2010
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Provider Practice Location Address
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Address Line | 1552 ORMSBY STATION CT
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City | LOUISVILLE
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State | KY
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Zip | 40223-4019
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Country | US
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Telephone | 310-717-2785
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Fax | 877-349-1770
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Provider Business Mailing Address
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Address Line | 22845 VENTURA BLVD # 367
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-1202
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Country | US
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Telephone | 310-717-2785
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Fax | 877-349-1770
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Authorized Official
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Title or Position | GP
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Name | MR. MUKESH GUPTA
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Credential | D.O
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Telephone | 310-717-2785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 32463
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License Number State | KY
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