Organization Active NPI

I S Gujral MD

  • Cardiovascular Disease Physician
  • Laguna Hills, CA
National Provider Identifier
1336529148
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A49536 Issued in CA
Legal business name
I S GUJRAL MD
Practice address
24953 Paseo de Valencia Ste 30a
Laguna Hills, CA 92653-4343
Phone
(949) 716-7981
Fax
(949) 716-7982
NPI assigned
Jun 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Nicolette Gonzalez
Title
Credentialing Manager
Phone
(951) 340-1000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X A49536 CA Primary
Clinical Cardiac Electrophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0001X A49536 CA

Addresses

Primary practice location

24953 Paseo de Valencia Ste 30a
Laguna Hills, CA 92653-4343

Mailing address

18 Newcastle LN
Laguna Niguel, CA 92677-9327
Phone (949) 307-2315

Other practice location 1

9810 Park St
Bellflower, CA 90706-5936
Phone (562) 925-9558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150826002571 CA Part B Supplier - Clinic/Group Practice 9739495409 Receives reassigned benefits from 3 practitioners
Practice locations: Bellflower, CA; Laguna Hills, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1336529148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 NEWCASTLE LN",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926779327",
            "telephone_number": "949-307-2315",
            "fax_number": "949-716-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24953 PASEO DE VALENCIA STE 30A",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534343",
            "telephone_number": "949-716-7981",
            "fax_number": "949-716-7982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9810 Park St",
            "address_purpose": "LOCATION",
            "city": "Bellflower",
            "state": "CA",
            "postal_code": "907065936",
            "country_code": "US",
            "telephone_number": "562-925-9558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "I S GUJRAL MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-05",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "NICOLETTE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "951-340-1000"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A49536",
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CA",
            "license": "A49536",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.