Healthcare Provider Details

I. General information

NPI: 1578339206
Provider Name (Legal Business Name): DAMANJOT & ELIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 S HAM LN STE B
LODI CA
95242-3524
US

IV. Provider business mailing address

431 S HAM LN STE B
LODI CA
95242-3524
US

V. Phone/Fax

Practice location:
  • Phone: 209-923-2226
  • Fax:
Mailing address:
  • Phone: 408-839-0074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DAMANJOT GADRI
Title or Position: ADMINISTRATOR
Credential:
Phone: 408-839-0074