Healthcare Provider Details

I. General information

NPI: 1285747709
Provider Name (Legal Business Name): JAIMAL SINGH SANGHA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

544 W 25TH ST
MERCED CA
95340-2828
US

IV. Provider business mailing address

544 W 25TH ST
MERCED CA
95340-2828
US

V. Phone/Fax

Practice location:
  • Phone: 209-383-3090
  • Fax: 209-383-3091
Mailing address:
  • Phone: 209-383-3090
  • Fax: 209-383-3091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC29149
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95029498
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: