Organization
HUSSAM EL GOHARY MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUSSAM IBRAHIM ELGOHARY M.D. (OWNER)
(510) 964-0458
Entity
Organization
Contact information
Practice address
2001 DWIGHT WAY RM 2350, BERKELEY, CA 94704-2608
(510) 204-4738
(510) 204-5892
Mailing address
2342 SHATTUCK AVE, #363, BERKELEY, CA 94704-1517
(510) 964-0458
(510) 964-0476
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A37602
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A376021
—
CA
Enumeration date
08/16/2010
Last updated
11/21/2011
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