Provider Demographics
NPI:1396306650
Name:GAUR, ANKUSH RAJ (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:ANKUSH
Middle Name:RAJ
Last Name:GAUR
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21303 OAKRIVER LN
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-4679
Mailing Address - Country:US
Mailing Address - Phone:661-253-9336
Mailing Address - Fax:
Practice Address - Street 1:21303 OAKRIVER LN
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-4679
Practice Address - Country:US
Practice Address - Phone:661-253-9336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA311712083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA31171OtherNCHEC