Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207R00000X | Internal Medicine | | A46605 | CALIFORNIA | No |
| 2 | 208M00000X | Hospitalist | | A46605 | CALIFORNIA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 00A466054 | OTHER | CALIFORNIA | MEDICARE PTAN - THREE RIVERS MEDICAL GROUP |
| 2 | 1881607695 | MEDICAID | CALIFORNIA | |
| 3 | BU991V | OTHER | CALIFORNIA | MEDICARE PTAN - RIDEOUT MEMORIAL HOSPITAL |
| 4 | 00A466050 | OTHER | CALIFORNIA | BLUE SHIELD PIN # |
| 5 | BU991Z | OTHER | CALIFORNIA | MEDICARE PTAN - YUBA CITY PRIMARY CARE & DIABETES 2 CLINIC INC. |
| 6 | BU991Y | OTHER | CALIFORNIA | MEDICARE PTAN - YUBA SUTTER HOSPITALISTS GROUP |
| 7 | BU991X | OTHER | CALIFORNIA | MEDICARE PTAN - N VALLEY CRITICAL CARE GROUP INC. |
| 8 | BU991W | OTHER | CALIFORNIA | MEDICARE PTAN - JASBIR KANG MD & SANJIV MIDHA MED A MEDICAL CORPORATION |
| 9 | 05D2036012 | OTHER | CALIFORNIA | CLIA FEDERAL ID# |