=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477460863
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAAN MEDICAL LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2026
-----------------------------------------------------
Last Update Date | 08/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11540 SASSARI LN
-----------------------------------------------------
City | PORTER RANCH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91326-4402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-329-3741
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2108 N ST STE 14844
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95816-5712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 747-368-2545
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | INDERPARTAP S PHANGUREH
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 530-329-3741
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------