Healthcare Provider Details

I. General information

NPI: 1659512325
Provider Name (Legal Business Name): HARBINDER S BRAR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3637 ARLINGTON AVE STE E202
RIVERSIDE CA
92506-3923
US

IV. Provider business mailing address

PO BOX 5878
RIVERSIDE CA
92517-5878
US

V. Phone/Fax

Practice location:
  • Phone: 951-683-4675
  • Fax: 951-683-1148
Mailing address:
  • Phone: 951-683-4675
  • Fax: 951-683-1148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA40011
License Number StateCA

VIII. Authorized Official

Name: MR. HARBINDER SINGH BRAR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 951-683-4675