Provider Demographics
NPI:1316506819
Name:BASRAN, SATNAM
Entity type:Individual
Prefix:
First Name:SATNAM
Middle Name:
Last Name:BASRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5467 E EUGENIA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-6382
Mailing Address - Country:US
Mailing Address - Phone:559-403-8993
Mailing Address - Fax:
Practice Address - Street 1:5467 E EUGENIA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-6382
Practice Address - Country:US
Practice Address - Phone:559-403-8993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle