=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952198038
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GARG SURGERY, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/22/2025
-----------------------------------------------------
Last Update Date | 04/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3628 E IMPERIAL HWY STE 408
-----------------------------------------------------
City | LYNWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90262-2646
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-554-4127
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3363 E 1ST ST
-----------------------------------------------------
City | LONG BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90803-2607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-382-7040
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | GAURAV GARG
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 410-382-7040
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0102X
-----------------------------------------------------
Taxonomy Name | Surgical Critical Care Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------