Healthcare Provider Details

I. General information

NPI: 1679004550
Provider Name (Legal Business Name): GURJASPREET KAUR BHATTAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 03/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD SUIT 4102
GAINESVILLE FL
32610-0265
US

IV. Provider business mailing address

401 EL MARGARITA RD
YUBA CITY CA
95993-9380
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0239
  • Fax: 352-265-1107
Mailing address:
  • Phone: 530-933-2908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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: