Healthcare Provider Details

I. General information

NPI: 1477460863
Provider Name (Legal Business Name): JAAN MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11540 SASSARI LN
PORTER RANCH CA
91326-4402
US

IV. Provider business mailing address

2108 N ST STE 14844
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 530-329-3741
  • Fax:
Mailing address:
  • Phone: 747-368-2545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: INDERPARTAP S PHANGUREH
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 530-329-3741