Provider Demographics
NPI:1255128252
Name:JKG NURSING, INC
Entity type:Organization
Organization Name:JKG NURSING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAGMOHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOTRA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:209-849-6543
Mailing Address - Street 1:25044 PEACHLAND AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-5730
Mailing Address - Country:US
Mailing Address - Phone:818-636-6749
Mailing Address - Fax:818-356-4380
Practice Address - Street 1:15722 VINCENNES ST
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-3166
Practice Address - Country:US
Practice Address - Phone:209-849-6543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty