Provider Demographics
NPI:1962563163
Name:BASRA, NARINDER S (MD)
Entity type:Individual
Prefix:DR
First Name:NARINDER
Middle Name:S
Last Name:BASRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1481 PLUMAS ST
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-2962
Mailing Address - Country:US
Mailing Address - Phone:530-674-4103
Mailing Address - Fax:530-674-4105
Practice Address - Street 1:1481 PLUMAS ST
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-2962
Practice Address - Country:US
Practice Address - Phone:530-674-4103
Practice Address - Fax:530-674-4105
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62968207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A629680Medicaid
CAG96480Medicare UPIN
00A629682Medicare ID - Type Unspecified