MEDICARE: HARSHDEEP SINGH BRAR FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	95019247	CA
2	163WH1000X	Hospice Registered Nurse	95202441	CA

General Provider Information

NPI Number	:	1144960659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARSHDEEP SINGH BRAR FNP

Provider Business Mailing Address
First Line	:	11130 OTSEGO ST APT 431
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-6831
Country	:	US
Telephone Number	:	559-394-8987
Fax Number	:

Provider Business Practice Location Address
First Line	:	11130 OTSEGO ST APT 431
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-6831
Country	:	US
Telephone Number	:	559-394-8987
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2022
Last Update Date	:	03/31/2022

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