Active NPI
Gul M Ebrahim, M.D.
- Psychiatry Physician
- Anaheim, CA
National Provider Identifier
1174786024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A42994
- Practice address
- 2911 E Coronado St
Anaheim, CA 92806-2525 - Phone
- (714) 688-4855
- Fax
- (714) 688-4894
- NPI assigned
- Jul 9, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A42994 | CA | Primary |
Addresses
Primary practice location
2911 E Coronado St
Anaheim, CA 92806-2525
Mailing address
2911 E Coronado St
Anaheim, CA 92806-2525
Phone (714) 688-4855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A42994 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215561600000",
"number": "1174786024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2911 E CORONADO ST",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928062525",
"telephone_number": "714-688-4855",
"fax_number": "714-688-4894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2911 E CORONADO ST",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928062525",
"telephone_number": "714-688-4855",
"fax_number": "714-688-4894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBRAHIM",
"first_name": "GUL",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-09",
"last_updated": "2008-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A42994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.