Provider Demographics
NPI:1033604236
Name:VIRK, JASJEET SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:JASJEET
Middle Name:SINGH
Last Name:VIRK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1901 TOWN AND COUNTRY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1820 FULLERTON AVE STE 115
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-3113
Practice Address - Country:US
Practice Address - Phone:951-817-5000
Practice Address - Fax:951-817-5002
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA174128207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine