Healthcare Provider Details

I. General information

NPI: 1992329759
Provider Name (Legal Business Name): LOVEPREET KAUR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2020
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7339 EL CAJON BLVD STE I
LA MESA CA
91942-7435
US

IV. Provider business mailing address

2598 MEDORA DR
GROVE CITY OH
43123-4612
US

V. Phone/Fax

Practice location:
  • Phone: 917-892-3518
  • Fax:
Mailing address:
  • Phone: 917-892-3518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number58521
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: