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JAGDEEP DEOL
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1366823049
Individual Registrant: JAGDEEP DEOL
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
500 ALFRED NOBEL DR STE 255A HERCULES, CA 94547-1843 US
Tel: 510-964-9647 Fax: --
Tel: 510-964-9647 Fax: --
Contact information for business:
500 ALFRED NOBEL DR STE 255A HERCULES, CA 94547-1843 US
Tel: 510-964-9647 Fax: --
Tel: 510-964-9647 Fax: --
Registration Information:
NPI: 1366823049
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | CA | 95002560 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
