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General NPI Number Information
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NPI Number | 1053027227
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Entity Type | Organization
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Legal Business Name | GAMDUR S. BRAR
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 2339 W CLEVELAND AVE STE 101
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City | MADERA
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State | CA
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Zip | 93637-8765
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Country | US
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Telephone | 559-675-9400
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Fax | 559-675-9404
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Provider Business Mailing Address
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Address Line | 2339 W CLEVELAND AVE STE 101
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City | MADERA
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State | CA
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Zip | 93637-8765
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Country | US
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Telephone | 559-675-9400
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Fax | 559-675-9404
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SUSAN CASAREZ
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Credential |
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Telephone | 559-675-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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