Provider Demographics
NPI:1144223934
Name:RANA, JASBIR KAUR (M,D)
Entity Type:Individual
Prefix:MRS
First Name:JASBIR
Middle Name:KAUR
Last Name:RANA
Suffix:
Gender:F
Credentials:M,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 PARK AVE
Mailing Address - Street 2:STE 208
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-1923
Mailing Address - Country:US
Mailing Address - Phone:925-676-7224
Mailing Address - Fax:925-676-1901
Practice Address - Street 1:2600 PARK AVE
Practice Address - Street 2:STE 208
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1923
Practice Address - Country:US
Practice Address - Phone:925-676-7224
Practice Address - Fax:925-676-1901
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29810174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC35365Medicare UPIN