Healthcare Provider Details

I. General information

NPI: 1477070969
Provider Name (Legal Business Name): GURWINDER KAUR BATH DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2017
Last Update Date: 08/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2628 EL CAMINO AVE STE C1
SACRAMENTO CA
95821-5936
US

IV. Provider business mailing address

2628 EL CAMINO AVE STE C1
SACRAMENTO CA
95821-5936
US

V. Phone/Fax

Practice location:
  • Phone: 559-862-9521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number33374
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: