Provider Demographics
NPI:1861569022
Name:BRAR, GURBINDER (MD)
Entity type:Individual
Prefix:DR
First Name:GURBINDER
Middle Name:
Last Name:BRAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:BRAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7075 N MAPLE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-8014
Mailing Address - Country:US
Mailing Address - Phone:559-323-0940
Mailing Address - Fax:559-323-0938
Practice Address - Street 1:7075 N MAPLE AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-8014
Practice Address - Country:US
Practice Address - Phone:559-323-0940
Practice Address - Fax:559-323-0938
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53763207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A537630Medicaid
CA05D961197OtherCLIA
CA05D961197OtherCLIA
CABB 4301913OtherDEA
CA05D961197OtherCLIA
CA00A537630Medicare PIN