Provider Demographics
NPI:1083977011
Name:MANGAT, NAVJOT KAUR (MD)
Entity Type:Individual
Prefix:
First Name:NAVJOT
Middle Name:KAUR
Last Name:MANGAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NAVJOT
Other - Middle Name:
Other - Last Name:KAUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:916-861-1486
Mailing Address - Fax:
Practice Address - Street 1:3000 Q ST FL 3
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-7058
Practice Address - Country:US
Practice Address - Phone:916-733-3400
Practice Address - Fax:916-733-5384
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA135212207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA135212OtherMEDICAL STATE LICENSE
CAFM5315153OtherDEA CERTIFICATE