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General NPI Number Information
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NPI Number | 1982592705
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Entity Type | Organization
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Legal Business Name | THE GORE MEDICAL GROUP INC.
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Dates
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Enumeration Date | 06/27/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 15708 POMERADO RD STE N201
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City | POWAY
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State | CA
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Zip | 92064-2066
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Country | US
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Telephone | 858-800-3850
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Fax |
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Provider Business Mailing Address
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Address Line | 6755 MIRA MESA BLVD STE 123 #169
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City | SAN DIEGO
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State | CA
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Zip | 92121-4311
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Country | US
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Telephone | 858-800-3850
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | NIKITA CHAND GORE
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Credential | MD
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Telephone | 909-374-1230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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