Provider Demographics
NPI:1316737547
Name:BHANGU, JASVIR
Entity type:Individual
Prefix:
First Name:JASVIR
Middle Name:
Last Name:BHANGU
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 ERSKIN FISH WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95835-1715
Mailing Address - Country:US
Mailing Address - Phone:530-415-2595
Mailing Address - Fax:
Practice Address - Street 1:5600 ERSKIN FISH WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95835-1715
Practice Address - Country:US
Practice Address - Phone:530-415-2595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)