Provider Demographics
NPI:1063947539
Name:CHEST AND CRITICAL CARE CONSULTANTS, A MEDICAL GROUP
Entity type:Organization
Organization Name:CHEST AND CRITICAL CARE CONSULTANTS, A MEDICAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARMOHINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GOGIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-577-2124
Mailing Address - Street 1:PO BOX 15090
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92803-5090
Mailing Address - Country:US
Mailing Address - Phone:714-232-2301
Mailing Address - Fax:714-202-2320
Practice Address - Street 1:1041 E YORBA LINDA BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3728
Practice Address - Country:US
Practice Address - Phone:714-577-9500
Practice Address - Fax:714-577-9504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW7183Medicare PIN