Provider Demographics
NPI:1154762946
Name:JAMMU, BALJIT K (DC)
Entity type:Individual
Prefix:DR
First Name:BALJIT
Middle Name:K
Last Name:JAMMU
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16929 MEEKLAND AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-1364
Mailing Address - Country:US
Mailing Address - Phone:510-343-4162
Mailing Address - Fax:
Practice Address - Street 1:1090 LA PLAYA DR
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-2142
Practice Address - Country:US
Practice Address - Phone:510-343-4162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 32664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor