Provider Demographics
NPI:1285747709
Name:SANGHA, JAIMAL SINGH (DC)
Entity type:Individual
Prefix:DR
First Name:JAIMAL
Middle Name:SINGH
Last Name:SANGHA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 W 25TH ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-2828
Mailing Address - Country:US
Mailing Address - Phone:209-383-3090
Mailing Address - Fax:209-383-3091
Practice Address - Street 1:544 W 25TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-2828
Practice Address - Country:US
Practice Address - Phone:209-383-3090
Practice Address - Fax:209-383-3091
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29149111N00000X
CANP95029498363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU99941Medicare UPIN