Provider Demographics
NPI:1003562141
Name:JAGDEEP GARCHA P.T
Entity Type:Organization
Organization Name:JAGDEEP GARCHA P.T
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAGDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-316-7200
Mailing Address - Street 1:3919 RUTLAN WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-3250
Mailing Address - Country:US
Mailing Address - Phone:916-316-7200
Mailing Address - Fax:
Practice Address - Street 1:1620 SANTA CLARA DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3558
Practice Address - Country:US
Practice Address - Phone:916-316-7200
Practice Address - Fax:916-529-4161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy