MEDICARE: CARE GASTROENTEROLOGY MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	A60836	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003964370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE GASTROENTEROLOGY MEDICAL GROUP

Provider Business Mailing Address
First Line	:	PO BOX 4517
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92690-4517
Country	:	US
Telephone Number	:	949-443-1546
Fax Number	:	949-443-1077

Provider Business Practice Location Address
First Line	:	655 CAMINO DE LOS MARES
Second Line	:	SUTE 123
City	:	SAN CLEMENTE
State	:	CA
Zip	:	92673-2809
Country	:	US
Telephone Number	:	949-443-1546
Fax Number	:	949-443-1077

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	NAVJYOT GUJRAL
Credential	:	MD
Telephone Number	:	949-734-4396

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	02/01/2024

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