Provider Demographics
NPI:1548401813
Name:VERMA, MINU (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:MINU
Middle Name:
Last Name:VERMA
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 N GREENFEILD
Mailing Address - Street 2:SUITE H
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230
Mailing Address - Country:US
Mailing Address - Phone:559-584-2771
Mailing Address - Fax:559-582-8548
Practice Address - Street 1:440 GREENFIELD AVE
Practice Address - Street 2:SUITE H
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3568
Practice Address - Country:US
Practice Address - Phone:559-584-2771
Practice Address - Fax:559-582-8548
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 16238363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical