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Organization
GJE INC.
Active
Organization
GJE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARRY FORKOSH MD (SOLE OWNER)
(646) 734-2585
Entity
Organization
Contact information
Practice address
5159 VIA EL MOLINO, NEWBURY PARK, CA 91320-6995
(646) 734-2585
(805) 426-8649
Mailing address
5159 VIA EL MOLINO, NEWBURY PARK, CA 91320-6995
(646) 734-2585
(805) 426-8649
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A123093
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750519385
TYPE 1 NPI
CA
01
—
A123093
MEDICAL LICENSE
CA
Enumeration date
02/12/2018
Last updated
02/12/2018
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