Basic Information
Provider Information
NPI: 1245478650
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JAMARAI
FirstName: GURLEEN
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1211 W LA PALMA AVE
Address2: SUITE 207
City: ANAHEIM
State: CA
PostalCode: 928012815
CountryCode: US
TelephoneNumber: 7147728282
FaxNumber: 7147726493
Practice Location
Address1: 1211 W LA PALMA AVE
Address2: SUITE 207
City: ANAHEIM
State: CA
PostalCode: 928012815
CountryCode: US
TelephoneNumber: 7147728282
FaxNumber: 7147726493
Other Information
ProviderEnumerationDate: 01/23/2009
LastUpdateDate: 08/01/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000XA106286CAN Allopathic & Osteopathic PhysiciansHospitalist 
207R00000XA106286CAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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