Basic Information
| Provider Information | |||||||||
| NPI: | 1083053342 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JAGUR | ||||||||
| FirstName: | PARMINDER | ||||||||
| MiddleName: | PAUL | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3701 J ST STE 220 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958165542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8553542242 | ||||||||
| FaxNumber: | 9165505003 | ||||||||
| Practice Location | |||||||||
| Address1: | 3701 J ST STE 220 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958165542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8553542242 | ||||||||
| FaxNumber: | 9165505003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2013 | ||||||||
| LastUpdateDate: | 05/18/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | E5214 | CA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
No ID Information.