Provider Demographics
NPI:1851478408
Name:JAGMEET K CHANN MD INC
Entity Type:Organization
Organization Name:JAGMEET K CHANN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMI
Authorized Official - Middle Name:L
Authorized Official - Last Name:TUELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-449-8060
Mailing Address - Street 1:6089 N FIRST
Mailing Address - Street 2:#101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710
Mailing Address - Country:US
Mailing Address - Phone:559-449-8060
Mailing Address - Fax:559-449-0330
Practice Address - Street 1:6089 N FIRST
Practice Address - Street 2:#101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:559-449-8060
Practice Address - Fax:559-449-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR000000103Medicare ID - Type Unspecified