Provider Demographics
NPI:1417979907
Name:KAUR, JASJEET (MD)
Entity Type:Individual
Prefix:DR
First Name:JASJEET
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20100 N 51ST AVE
Mailing Address - Street 2:SUITE F-635
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5125
Mailing Address - Country:US
Mailing Address - Phone:623-266-7858
Mailing Address - Fax:623-444-9810
Practice Address - Street 1:20100 N 51ST AVE
Practice Address - Street 2:SUITE F-635
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5125
Practice Address - Country:US
Practice Address - Phone:623-266-7858
Practice Address - Fax:623-444-9810
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002555207RE0101X
AZ36320207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH86303Medicare UPIN