Provider Demographics
NPI:1255193058
Name:JEEVA HEALTHCARE INC
Entity type:Organization
Organization Name:JEEVA HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHAREHOLDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHWINI
Authorized Official - Middle Name:V
Authorized Official - Last Name:MALLAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:507-271-9864
Mailing Address - Street 1:2834 HAMNER AVE # 456
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-1929
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18660 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2316
Practice Address - Country:US
Practice Address - Phone:760-515-1911
Practice Address - Fax:442-292-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty