Healthcare Provider Details

I. General information

NPI: 1487177796
Provider Name (Legal Business Name): JAIMAL SINGH JOHAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 SISTER MARY COLUMBA DR
RED BLUFF CA
96080-4327
US

IV. Provider business mailing address

2550 SISTER MARY COLUMBA DR
RED BLUFF CA
96080-4327
US

V. Phone/Fax

Practice location:
  • Phone: 530-529-8000
  • Fax:
Mailing address:
  • Phone: 530-529-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD484899
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA166712
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD484899
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: