Provider Demographics
NPI:1982384962
Name:PHAGURA, GURPREET KAUR
Entity Type:Individual
Prefix:
First Name:GURPREET
Middle Name:KAUR
Last Name:PHAGURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18087 S MACARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95304-9427
Mailing Address - Country:US
Mailing Address - Phone:209-430-9267
Mailing Address - Fax:
Practice Address - Street 1:18087 S MACARTHUR DR
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95304-9427
Practice Address - Country:US
Practice Address - Phone:209-430-9267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)