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MINI GANTLA M.D
NPI 1114869740
Student in an Organized Health Care Education/Training Program in Fresno, CA

Active since April 06, 2026
155 N FRESNO STREET, FRESNO, CA 93701(559) 499-6556 Get Directions Write a Review

NPPES record last updated: May 22, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 22, 2026, Apr 9, 2026 (2 updates tracked since 2026).

About Mini Gantla M.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MINI GANTLA M.D (NPI 1114869740) is an individual student in an organized health care education/training program in Fresno, California and active in the NPI registry since April 2026.

NPPES Registry Identity

NPI1114869740
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMINI GANTLACredential: M.D
Location Address155 N FRESNO STREETFresno, CA 93701
Mailing Address155 N Fresno StreetFresno, CA 93701 · (559) 499-6556
Phone(559) 499-6556
Sole ProprietorYes
Enumeration DateApril 6, 2026
Last NPPES UpdateMay 22, 20262 updates tracked since enumeration
NPPES CertifiedMay 22, 2026
✔ NPI 1114869740 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
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.
155 N FRESNO STREET, Fresno, CA 93701
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHREYAA RAJPAL
Student in an Organized Health Care Education/Training Program
155 N FRESNO STREET
FRESNO, CA 93701
Fresno County (559) 499-6550
MS. SARANYA SASIDHARAN M.D.
Internal Medicine (Gastroenterology)
155 N FRESNO STREET, DEPARTMENT OF GASTROENTEROLOGY
FRESNO, CA 93701
Fresno County (559) 499-6500
DR. BASHAR TANOUS MBCHB
Internal Medicine
155 N FRESNO STREET
FRESNO, CA 93701
Fresno County (559) 499-6500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mini Gantla's NPI number?

The NPI number for Mini Gantla is 1114869740. It was assigned to this individual provider in the NPPES registry on April 6, 2026.

Where is Mini Gantla located?

Mini Gantla practices at 155 N Fresno Street, Fresno, CA 93701. The listed phone number is (559) 499-6556.

What is Mini Gantla's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Mini Gantla was last updated on May 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.