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Individual

MRS. JASMEET KAUR MANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1901 MITCHELL RD STE C, CERES, CA 95307
(209) 537-8971
(209) 537-8974
Mailing address
PO BOX 186, CERES, CA 95307-0186
(209) 537-8971
(209) 537-8974

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14549
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5033839
CA
01
DB428A
MEDICARE GROUP PTAN
CA
Enumeration date
10/30/2012
Last updated
07/31/2018
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