Provider Demographics
NPI:1992026389
Name:SRAI, PARMJIT K
Entity type:Individual
Prefix:MRS
First Name:PARMJIT
Middle Name:K
Last Name:SRAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 422
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95378-0422
Mailing Address - Country:US
Mailing Address - Phone:209-321-3830
Mailing Address - Fax:209-833-9845
Practice Address - Street 1:18809 PHILIP MARTIN CT
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95304-8333
Practice Address - Country:US
Practice Address - Phone:209-321-3830
Practice Address - Fax:209-833-9845
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-20
Last Update Date:2010-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA$$$$$$$$$OtherTRANSPORT