Provider Demographics
NPI:1003626276
Name:CUA, GAN AND BIEN MEDICAL CORPORATION
Entity type:Organization
Organization Name:CUA, GAN AND BIEN MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ZAHRA
Authorized Official - Middle Name:RAHIM
Authorized Official - Last Name:UNWALLA
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:909-267-8540
Mailing Address - Street 1:1433 W MERCED AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3402
Mailing Address - Country:US
Mailing Address - Phone:626-960-4989
Mailing Address - Fax:
Practice Address - Street 1:1433 W MERCED AVE STE 114
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3402
Practice Address - Country:US
Practice Address - Phone:626-960-4989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-09
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty