Healthcare Provider Details

I. General information

NPI: 1629337449
Provider Name (Legal Business Name): JATINDER KAJLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4905 STOCKTON BLVD UNIT 108
SACRAMENTO CA
95820-5405
US

IV. Provider business mailing address

4905 STOCKTON BLVD UNIT 108
SACRAMENTO CA
95820-5405
US

V. Phone/Fax

Practice location:
  • Phone: 916-538-2012
  • Fax:
Mailing address:
  • Phone: 916-538-2012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA135215
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: