Provider Demographics
NPI:1477740702
Name:BANGA, HARPREET K
Entity Type:Individual
Prefix:
First Name:HARPREET
Middle Name:K
Last Name:BANGA
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 1:3100 STOCKTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1417
Mailing Address - Country:US
Mailing Address - Phone:916-736-3188
Mailing Address - Fax:
Practice Address - Street 1:3100 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-1417
Practice Address - Country:US
Practice Address - Phone:916-736-3188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NPI 1346513058OtherNPI 1346513058
NPI 1346513058OtherPTAN 6713060001