Organization
PARDEEP BRAR M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PARDEEP BRAR M.D. (OWNER)
(209) 484-9855
Entity
Organization
Contact information
Practice address
803 COFFEE RD, SUITE #5, MODESTO, CA 95355-4227
(209) 484-9855
Mailing address
PO BOX 3346, MODESTO, CA 95353-3346
(209) 484-9855
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
C54142
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EP663Z
MEDICARE INDIVIDUAL PTAN
CA
Enumeration date
06/08/2012
Last updated
06/08/2012
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