Individual provider Active NPI

Gopu Premrajan

  • Pain Medicine Physician
  • Anaheim, CA
National Provider Identifier
1881332732
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
A209283 Issued in CA
Practice address
1717 E Lincoln Ave
Anaheim, CA 92805-4345
Phone
(714) 635-2642
NPI assigned
May 21, 2022
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A209283 CA
Pain Medicine Physician 208VP0000X A209283 CA Primary

Addresses

Primary practice location

1717 E Lincoln Ave
Anaheim, CA 92805-4345

Mailing address

16702 Valley View Ave
La Mirada, CA 90638-5824
Phone (714) 367-5391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20251129000520 NY Practitioner - Emergency Medicine 0042703944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Park Ave FL
Suite 11
New York, NY 10016-5818

700 Hicksville Rd
Bethpage, NY 11714-3471

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A209283CAMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Nov 1, 2025 Accepting new patients
New York University Emergency Medicine CurrentSince Nov 1, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: gpremrajan711588@nyumc.direct-ci.com

Organizations & group practices 2

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1653091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1881332732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16702 VALLEY VIEW AVE",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906385824",
            "telephone_number": "714-367-5391",
            "fax_number": "714-635-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 E LINCOLN AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928054345",
            "telephone_number": "714-635-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREMRAJAN",
        "first_name": "GOPU",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-21",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A209283",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "A209283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.