Provider Demographics
NPI:1265301881
Name:JAGLEGACY MEDICAL GROUP LLC
Entity type:Organization
Organization Name:JAGLEGACY MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SUKHJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-904-7476
Mailing Address - Street 1:5352 TRIMONTI CIR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8730
Mailing Address - Country:US
Mailing Address - Phone:559-904-7476
Mailing Address - Fax:559-904-7476
Practice Address - Street 1:5352 TRIMONTI CIR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8730
Practice Address - Country:US
Practice Address - Phone:559-904-7476
Practice Address - Fax:559-904-7476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)