Provider Demographics
NPI:1790853760
Name:BASRAI, KARANJIT SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:KARANJIT
Middle Name:SINGH
Last Name:BASRAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KARANJIT
Other - Middle Name:SINGH
Other - Last Name:BASRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1540 RIVER PARK DR STE 202
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4609
Mailing Address - Country:US
Mailing Address - Phone:916-245-6192
Mailing Address - Fax:916-245-5619
Practice Address - Street 1:SUTTER ROSEVILLE MEDICAL CENTER.
Practice Address - Street 2:6, MEDICAL PLAZA DR
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3037
Practice Address - Country:US
Practice Address - Phone:916-878-2669
Practice Address - Fax:916-878-2622
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73010208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00730100Medicare ID - Type Unspecified
CAH52964Medicare UPIN