=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235436205
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. HARSIMRAN K BAINS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2011
-----------------------------------------------------
Last Update Date | 03/24/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9450 FAIRWAY DR STE 110
-----------------------------------------------------
City | ROSEVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95678-3588
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-771-8464
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 153 COLLEGE HILL WAY
-----------------------------------------------------
City | YUBA CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95993-6090
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-300-0383
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 60215
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------