Healthcare Provider Details

I. General information

NPI: 1568133585
Provider Name (Legal Business Name): RAJDEEP KAUR PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 09/21/2021
Certification Date: 09/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 E MANNING AVE
REEDLEY CA
93654-9467
US

IV. Provider business mailing address

235 E NORTHRIDGE DR
DINUBA CA
93618-3530
US

V. Phone/Fax

Practice location:
  • Phone: 800-492-4227
  • Fax: 559-634-0318
Mailing address:
  • Phone: 559-737-8025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: