| Gastro Care Institute | |
|
1331 W Avenue J Ste 202 Lancaster CA 93534-2954 | |
| (661) 529-7550 | |
| (661) 529-7560 |
| Full Name | Gastro Care Institute |
|---|---|
| Speciality | Internal Medicine |
| Location | 1331 W Avenue J Ste 202, Lancaster, California |
| Authorized Official Name and Position | Vivaik Tyagi (PRESIDENT) |
| Authorized Official Contact | 6615757603 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastro Care Institute Po Box 5688 Lancaster CA 93539-5688 Ph: (661) 529-7550 | Gastro Care Institute 1331 W Avenue J Ste 202 Lancaster CA 93534-2954 Ph: (661) 529-7550 |
| NPI Number | 1326514746 |
|---|---|
| Provider Enumeration Date | 10/23/2018 |
| Last Update Date | 10/23/2018 |
| Medicare PECOS PAC ID | 7214273481 |
|---|---|
| Medicare Enrollment ID | O20190108003937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326514746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Kumari Surang Wickramasinghe |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1043204712 PECOS PAC ID: 0749236925 Enrollment ID: I20050330001086 |
| Provider Name | Vivaik Tyagi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073612545 PECOS PAC ID: 4486682556 Enrollment ID: I20070510000491 |
| Provider Name | Deepthi K Karunasiri |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1285832394 PECOS PAC ID: 6800980442 Enrollment ID: I20070913000476 |
| Provider Name | Kumaravel Perumalsamy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851484323 PECOS PAC ID: 4587663356 Enrollment ID: I20080915000471 |
| Provider Name | Prithviraj Dharmaraja |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932111424 PECOS PAC ID: 0749208312 Enrollment ID: I20090115000518 |
| Provider Name | Diana Aurora Uribe-tanus |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1780069054 PECOS PAC ID: 1254648819 Enrollment ID: I20150916001881 |
| Provider Name | Duminda Bernard Suraweera |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629411756 PECOS PAC ID: 8921307885 Enrollment ID: I20160427000513 |
| Provider Name | Andreana A Coyle |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1053858498 PECOS PAC ID: 1850676065 Enrollment ID: I20170329002568 |
| Provider Name | Relly Mer Fuentebella Segovia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780303248 PECOS PAC ID: 7810362969 Enrollment ID: I20230404000686 |
| Provider Name | Marina Michelle Bragasin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376267971 PECOS PAC ID: 6305211293 Enrollment ID: I20230406001034 |
| Provider Name | Shahla Khan |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1548513567 PECOS PAC ID: 1153786660 Enrollment ID: I20230504001895 |
| Provider Name | Cecilia Jane Fisher |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1457060634 PECOS PAC ID: 1456713437 Enrollment ID: I20230809000668 |
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