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General NPI Number Information
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NPI Number | 1598180515
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Entity Type | Organization
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Legal Business Name | GRACE EXTENDED & MEDICAL SERVICES INC
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Dates
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Enumeration Date | 02/27/2014
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 901 H ST 310
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City | SACRAMENTO
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State | CA
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Zip | 95814-1805
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Country | US
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Telephone | 916-212-2575
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Fax |
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Provider Business Mailing Address
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Address Line | 5050 LAGUNA BLVD STE 112
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City | ELK GROVE
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State | CA
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Zip | 95758-4151
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Country | US
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Telephone | 916-212-2575
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARVIND KAUR BEHL
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Credential | M.D
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Telephone | 916-212-2575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A055920
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License Number State | CA
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