MEDICARE: VAJRAVYAPAAR LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1942151089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VAJRAVYAPAAR LLC

Provider Business Mailing Address
First Line	:	30 N GOULD ST STE N
Second Line	:
City	:	SHERIDAN
State	:	WY
Zip	:	82801-6317
Country	:	US
Telephone Number	:	640-248-9110
Fax Number	:

Provider Business Practice Location Address
First Line	:	3522 SAN MARINO AVE
Second Line	:
City	:	CLOVIS
State	:	CA
Zip	:	93619-8797
Country	:	US
Telephone Number	:	640-248-9110
Fax Number	:

Authorized Official
Title or Position	:	SOLE MBR
Name	:	SACHIN MALIK
Credential	:
Telephone Number	:	640-248-9110

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “VAJRAVYAPAAR LLC ” Practice Location

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