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GAVELYN POONNOPATAM DO NPI 1962021378


NPI Information

NPI: 1962021378
Provider Name: GAVELYN POONNOPATAM, DO
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
155 CALLE PORTAL
SIERRA VISTA, AZ
ZIP 85635
Phone: (520) 364-1429
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Gavelyn Poonnopatam, DO is a family medicine in Sierra Vista, AZ with 4 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Gavelyn Poonnopatam, DO NPI is 1962021378. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: WESTERN UN OF HLTH SCIENCES, COL OF PODIATRIC MED
Graduation Year:2020

The provider's business location address is:

155 CALLE PORTAL
SIERRA VISTA, AZ
ZIP 85635-900
Phone: (520) 364-1429

The NPI 1962021378 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/15/2020 and was last updated on 8/11/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine010273ARIZONAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.