Healthcare Provider Details

I. General information

NPI: 1861929499
Provider Name (Legal Business Name): KAUR EXPRESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17099 NILE LILY WAY
FONTANA CA
92337-6874
US

IV. Provider business mailing address

17099 NILE LILY WAY
FONTANA CA
92337-6874
US

V. Phone/Fax

Practice location:
  • Phone: 909-244-8968
  • Fax: 951-344-8380
Mailing address:
  • Phone: 909-244-8968
  • Fax: 951-344-8380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JASBIR KAUR
Title or Position: OWNER
Credential:
Phone: 909-244-6889