Basic Information
| Provider Information | |||||||||
| NPI: | 1366844862 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUTHRA | ||||||||
| FirstName: | NAVIN | ||||||||
| MiddleName: | GOGNA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3768 | ||||||||
| Address2: | 1763 GROGAN AVENUE | ||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953443768 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2097257149 | ||||||||
| FaxNumber: | 2097260134 | ||||||||
| Practice Location | |||||||||
| Address1: | 374 W OLIVE AVE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953483181 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093845766 | ||||||||
| FaxNumber: | 2093834230 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2014 | ||||||||
| LastUpdateDate: | 12/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | A133401 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.