Basic Information
| Provider Information | |||||||||
| NPI: | 1003154824 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAUR | ||||||||
| FirstName: | JASVIR | ||||||||
| MiddleName: | K | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8383 CROWDER LN | ||||||||
| Address2: | |||||||||
| City: | ROSEVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 957479758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9162577932 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8383 CROWDER LN | ||||||||
| Address2: | |||||||||
| City: | ROSEVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 957479758 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9162577932 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2013 | ||||||||
| LastUpdateDate: | 01/29/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246RP1900X | CPT00001392 | CA | Y | Technologists, Technicians & Other Technical Service Providers | Technician, Pathology | Phlebotomy |
No ID Information.