MEDICARE: JAGDEEP KAUR MD

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	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician	C170263	CA
2	2084P0802X	Addiction Psychiatry Physician	C170263	CA

General Provider Information

NPI Number	:	1467682260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAGDEEP KAUR MD

Provider Business Mailing Address
First Line	:	8120 TIMBERLAKE WAY STE 210B
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-5414
Country	:	US
Telephone Number	:	916-917-7316
Fax Number	:	866-481-8756

Provider Business Practice Location Address
First Line	:	8120 TIMBERLAKE WAY STE 210B
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-5414
Country	:	US
Telephone Number	:	916-917-7316
Fax Number	:	866-481-8756

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

Provider Enumeration Date	:	07/15/2009
Last Update Date	:	07/17/2024

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