Individual provider Active NPI

Gurpreet Singh Ahuja, MD

  • Otolaryngology Physician
  • Orange, CA
National Provider Identifier
1013970169
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A54475 Issued in CA
Practice address
1010 W la Veta Ave
Suite 640
Orange, CA 92868-4300
Phone
(714) 633-4020
Fax
(714) 953-5462
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A54475 CA Primary

Addresses

Primary practice location

1010 W la Veta Ave
Suite 640
Orange, CA 92868-4300

Mailing address

1010 W la Veta Ave
Ste 640
Orange, CA 92868-4300
Phone (714) 633-4020

Other identifiers 1

IdentifierTypeStateIssuer
00A544750MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051018001258 CA Practitioner - Pediatric MedicinePractitioner - Otolaryngology 9436175577 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A54475CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital of Orange County CurrentSince Oct 13, 2018 Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
Children'S Hospital of Orange County Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

455 S Main St
Orange, CA 92868
Phone (714) 289-4511

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

1201 W La Veta Ave
Ste 311
Orange, CA 92868
Phone (714) 633-4020

1201 W La Veta Ave
Orange, CA 92868
Phone (714) 509-8481

Dept LA 21333
Pasadena, CA 91185

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1013970169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE",
            "address_2": "STE 640",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684300",
            "telephone_number": "714-633-4020",
            "fax_number": "714-953-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 W LA VETA AVE",
            "address_2": "SUITE 640",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684300",
            "telephone_number": "714-633-4020",
            "fax_number": "714-953-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHUJA",
        "first_name": "GURPREET",
        "middle_name": "SINGH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A54475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A544750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.