Healthcare Provider Details

I. General information

NPI: 1588011860
Provider Name (Legal Business Name): NAVPREET KAUR BAINS D.O..
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N PEPPER AVE
COLTON CA
92324-1801
US

IV. Provider business mailing address

400 N PEPPER AVE
COLTON CA
92324-1801
US

V. Phone/Fax

Practice location:
  • Phone: 909-580-1366
  • Fax:
Mailing address:
  • Phone: 909-580-1366
  • Fax: 909-580-1363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number20A22379
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2021019218
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number2021019218
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number20A22379
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: