Individual provider · Type 1 NPI
Mini Gantla, MD
Student in an Organized Health Care Education/Training Program · Fresno, CA
NPI number
1114869740
Active
Practice location
155 N Fresno Street
Fresno, CA 93701
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
3 other providers at this address
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About NPI 1114869740
Mini Gantla, MD's National Provider Identifier is 1114869740, issued on Apr 6, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fresno, CA. The record was last updated on May 22, 2026.