Healthcare Provider Details

I. General information

NPI: 1114881232
Provider Name (Legal Business Name): NAVDEEPPAL KAUR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34538 VENTURI AVE
BEAUMONT CA
92223-7474
US

IV. Provider business mailing address

34538 VENTURI AVE
BEAUMONT CA
92223-7474
US

V. Phone/Fax

Practice location:
  • Phone: 562-335-2658
  • Fax:
Mailing address:
  • Phone: 818-517-2497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95231570
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: