MEDICARE: DR. LANA GAFTER M.D.

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	207RN0300X	Nephrology Physician	A92610	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ02094Z	OTHER		MEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1376529552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LANA GAFTER M.D.

Provider Business Mailing Address
First Line	:	151 N SUNRISE AVE
Second Line	:	SUITE 1205
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-2924
Country	:	US
Telephone Number	:	916-789-1505
Fax Number	:	916-789-1513

Provider Business Practice Location Address
First Line	:	151 N SUNRISE AVE
Second Line	:	SUITE 1205
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-2924
Country	:	US
Telephone Number	:	916-789-1505
Fax Number	:	916-789-1513

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	12/15/2014

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Directions to “ DR. LANA GAFTER M.D.” Practice Location

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