Healthcare Provider Details

I. General information

NPI: 1376295808
Provider Name (Legal Business Name): JASKIRAN KAUR GREWAL OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 ESPLANADE
CHICO CA
95973-0207
US

IV. Provider business mailing address

3401 ESPLANADE
CHICO CA
95973-0207
US

V. Phone/Fax

Practice location:
  • Phone: 530-895-1727
  • Fax: 530-895-1506
Mailing address:
  • Phone: 530-895-1727
  • Fax: 530-895-1506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number35086
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: