Prakasam, Gnanagurdasan

Prakasam, Gnanagurdasan is an individual health care provider with primary practice located at 3814 Auburn Blvd 72, Sacramento CA 95821-2123. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Endocrinology, which is considered as his primary health care specialty. Prakasam, Gnanagurdasan can be contacted via phone (916) 426-1902.

Contact Information

Primary practice address
3814 Auburn Blvd 72 Sacramento CA 95821-2123
Phone: (916) 426-1902
Fax: (916) 426-1940
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Endocrinology 2080P0205X A65908 California

Profile Details

NPI number 1871586065
LBN Legal business name Prakasam, Gnanagurdasan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated Apr 4th, 2013 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1871586065 NPPES
California MEDICAID 00A659080

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