Provider Demographics
NPI:1891782009
Name:BASI, UPINDER KAUR (MD)
Entity Type:Individual
Prefix:
First Name:UPINDER
Middle Name:KAUR
Last Name:BASI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:UPINDER
Other - Middle Name:KAUR
Other - Last Name:GARCHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1425 W H ST
Mailing Address - Street 2:STE 380
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361-3588
Mailing Address - Country:US
Mailing Address - Phone:209-847-0314
Mailing Address - Fax:209-847-4175
Practice Address - Street 1:1425 W H ST
Practice Address - Street 2:STE 380
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-3588
Practice Address - Country:US
Practice Address - Phone:209-847-0314
Practice Address - Fax:209-847-4175
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA065829207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA110202244OtherRAILROAD MEDICARE
CA110202244OtherRAILROAD MEDICARE