Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP0504X | Public Medicine | EL 1694 | CA |
N | 213EP1101X | Primary Podiatric Medicine | EL 1694 | CA |
N | 111NR0200X | Radiology | EL 1694 | CA |
N | 213ER0200X | Radiology | EL 1694 | CA |
N | 2081S0010X | Sports Medicine | EL 1694 | CA |
N | 213ES0000X | Sports Medicine | EL 1694 | CA |
Y | 213ES0103X | Foot & Ankle Surgery | E4869 | CA |
N | 213ES0103X | Foot & Ankle Surgery | EL 1694 | CA |
N | 213ES0131X | Foot Surgery | EL 1694 | CA |
NPI | 1619117181 |
---|---|
Provider Name | Dr. Manpreet Kaur Brar Magoon |
First Address | Merced, CA 95341-6805 |
Second Address | Modesto, CA 95350-4437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2009 |
Last Update Date | 25/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E4869 | CA LICENSE (01) | CA |