MEDICARE: JASMINE GHUMAN 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	207R00000X	Internal Medicine Physician	A176699	CA

General Provider Information

NPI Number	:	1558914465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE GHUMAN MD

Provider Business Mailing Address
First Line	:	2015 S MARIPOSA RD
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95205-7735
Country	:	US
Telephone Number	:	209-751-1900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2015 S MARIPOSA RD
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95205-7735
Country	:	US
Telephone Number	:	209-373-2816
Fax Number	:

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

Provider Enumeration Date	:	07/19/2019
Last Update Date	:	03/06/2024

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