Provider Demographics
NPI:1033440441
Name:PAL, AMANDEEP
Entity Type:Individual
Prefix:
First Name:AMANDEEP
Middle Name:
Last Name:PAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 JEWETT AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-6243
Mailing Address - Country:US
Mailing Address - Phone:925-473-9285
Mailing Address - Fax:
Practice Address - Street 1:960 JEWETT AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-6243
Practice Address - Country:US
Practice Address - Phone:925-473-9285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT37842246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACPT37842OtherCERTIFIED PHLEBOTOMY TECHNICIAN