Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | E4574 | CA |
N | 213ES0103X | Foot & Ankle Surgery | E4574 | CA |
NPI | 1073563938 |
---|---|
Provider Name | Harprit K Bajwa |
First Address | Cameron Park, CA 95682-8277 |
Second Address | Cameron Park, CA 95682-8277 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 22/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E45740 | CA LICENSE (01) | CA |
U85193 | (02) | CA |