Provider Demographics
NPI:1750510293
Name:HOTHI, JASPAL SINGH (MD)
Entity Type:Individual
Prefix:
First Name:JASPAL
Middle Name:SINGH
Last Name:HOTHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11175 CAMPUS STREET COLEMAN PAVILION-A1120
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350-0001
Mailing Address - Country:US
Mailing Address - Phone:909-558-9626
Mailing Address - Fax:
Practice Address - Street 1:250 E CAROLINE ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3747
Practice Address - Country:US
Practice Address - Phone:909-651-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301109495208000000X, 2080S0012X, 2080P0214X
CODR.00640072080P0214X
CAC1729702080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine