Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | A53283 | CA |
NPI | 1225195365 |
---|---|
Provider Name | Sukhbir Kaur |
First Address | Fresno, CA 93710-5290 |
Second Address | Fresno, CA 93710-5290 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A532830 | (05) | CA |
G28767 | (02) | CA |