Healthcare Provider Details

I. General information

NPI: 1154917318
Provider Name (Legal Business Name): JASPREET SOMAL M.D., A.P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2020
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1687 ERRINGER RD STE 215
SIMI VALLEY CA
93065-6510
US

IV. Provider business mailing address

4776 ALLIED RD
SAN DIEGO CA
92120-2412
US

V. Phone/Fax

Practice location:
  • Phone: 805-522-4004
  • Fax: 805-583-3709
Mailing address:
  • Phone: 216-776-8923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: JASPREET SOMAL
Title or Position: OWNER
Credential: MD
Phone: 805-522-4004