Nagendra, Gautam

Nagendra, Gautam is an individual health care provider with primary practice located at 11234 Anderson St , Loma Linda CA 92354-2804. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatric Gastroenterology. Allopathic & Osteopathic Physicians / Pediatric Gastroenterology is his primary health care specialty. Nagendra, Gautam can be contacted via phone (909) 558-4773.

Contact Information

Primary practice address
11234 Anderson St Loma Linda CA 92354-2804
Phone: (909) 558-4773
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X A155780 California

Profile Details

NPI number 1265827802
LBN Legal business name Nagendra, Gautam
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2015
Last updated Oct 5th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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