Healthcare Provider Details

I. General information

NPI: 1821822131
Provider Name (Legal Business Name): JASMILAN SINGH DHESI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2484 S BUNDY DR
FRESNO CA
93727-9036
US

IV. Provider business mailing address

2484 S BUNDY DR
FRESNO CA
93727-9036
US

V. Phone/Fax

Practice location:
  • Phone: 559-801-5502
  • Fax:
Mailing address:
  • Phone: 559-801-5502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberY7212817
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: