Healthcare Provider Details

I. General information

NPI: 1194630178
Provider Name (Legal Business Name): DAMANPREET SINGH BHATIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5425 MOSSY STONE WAY
RANCHO CORDOVA CA
95742-8123
US

IV. Provider business mailing address

5425 MOSSY STONE WAY
RANCHO CORDOVA CA
95742-8123
US

V. Phone/Fax

Practice location:
  • Phone: 916-472-4244
  • Fax:
Mailing address:
  • Phone: 916-472-4244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number342701837
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: