Provider Demographics
NPI:1275018681
Name:KAUR, RAJWINDER
Entity Type:Individual
Prefix:
First Name:RAJWINDER
Middle Name:
Last Name:KAUR
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 1:2345 E PRATER WAY STE 207
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-9634
Mailing Address - Country:US
Mailing Address - Phone:661-256-6365
Mailing Address - Fax:661-256-9295
Practice Address - Street 1:2559 W ROSAMOND BLVD STE D
Practice Address - Street 2:
Practice Address - City:ROSAMOND
Practice Address - State:CA
Practice Address - Zip Code:93560-6267
Practice Address - Country:US
Practice Address - Phone:661-256-6365
Practice Address - Fax:661-256-9295
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95009535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily