Healthcare Provider Details

I. General information

NPI: 1194430496
Provider Name (Legal Business Name): GURBINDER KAUR LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2023
Last Update Date: 01/20/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 ADELINE ST
OAKLAND CA
94607-2608
US

IV. Provider business mailing address

4412 ELAISO CMN
FREMONT CA
94536-5626
US

V. Phone/Fax

Practice location:
  • Phone: 510-835-9610
  • Fax:
Mailing address:
  • Phone: 510-300-5207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN262227
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: