1851794457 NPI number — JASPREET KAUR KHOSA PHARMD.

Table of content: JASPREET KAUR KHOSA PHARMD. (NPI 1851794457)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851794457 NPI number — JASPREET KAUR KHOSA PHARMD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHOSA
Provider First Name:
JASPREET
Provider Middle Name:
KAUR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KAUR
Provider Other First Name:
JASPREET
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1851794457
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/28/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2020 E COPPER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93730-5402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-433-1290
Provider Business Mailing Address Fax Number:
559-433-1296

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2020 E COPPER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93730-5402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-433-1290
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/27/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  71466 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RPH 71466 . This is a "CALIFORNIA BOARD OF PHARMACY" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".