Provider Demographics
NPI:1174788426
Name:DSOUZA, GEHAAN FRANKLIN (MD)
Entity type:Individual
Prefix:DR
First Name:GEHAAN
Middle Name:FRANKLIN
Last Name:DSOUZA
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 1:455 S LAURELTREE DR
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-1648
Mailing Address - Country:US
Mailing Address - Phone:714-974-1566
Mailing Address - Fax:
Practice Address - Street 1:3144 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2194
Practice Address - Country:US
Practice Address - Phone:714-456-5532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANOT LISENCED208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery