Healthcare Provider Details

I. General information

NPI: 1497542302
Provider Name (Legal Business Name): HARMIT SINGH PABLA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4652 WHITNEY AVE
SACRAMENTO CA
95821-4172
US

IV. Provider business mailing address

4652 WHITNEY AVE
SACRAMENTO CA
95821-4172
US

V. Phone/Fax

Practice location:
  • Phone: 916-241-3282
  • Fax:
Mailing address:
  • Phone: 916-241-3282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number6576557
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: