Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT15410 | CA |
NPI | 1003307679 |
---|---|
Provider Name | Jaspreet Singh Basi |
First Address | San Diego, CA 92130-8689 |
Second Address | San Diego, CA 92130-8689 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2018 |
Last Update Date | 19/05/2018 |