Provider Demographics
NPI:1174551568
Name:GADGIL, UDAY G (MD)
Entity type:Individual
Prefix:DR
First Name:UDAY
Middle Name:G
Last Name:GADGIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 N THIRD AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723
Mailing Address - Country:US
Mailing Address - Phone:626-859-2898
Mailing Address - Fax:626-859-2895
Practice Address - Street 1:315 N THIRD AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723
Practice Address - Country:US
Practice Address - Phone:626-859-2898
Practice Address - Fax:626-859-2895
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40126207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A401261Medicaid
A29056Medicare UPIN
A40126Medicare ID - Type Unspecified