Provider Demographics
NPI:1801637186
Name:BOPARAI, SUKHMAN
Entity type:Individual
Prefix:
First Name:SUKHMAN
Middle Name:
Last Name:BOPARAI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:SUKHMAN
Other - Middle Name:KAUR
Other - Last Name:BOPARAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7138 N. MILLBROOK
Mailing Address - Street 2:#105
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720
Mailing Address - Country:US
Mailing Address - Phone:559-450-6531
Mailing Address - Fax:
Practice Address - Street 1:7138 N. MILLBROOK
Practice Address - Street 2:#105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720
Practice Address - Country:US
Practice Address - Phone:559-450-6531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2025-05-05
Deactivation Date:2025-01-16
Deactivation Code:
Reactivation Date:2025-05-05
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program