Provider Demographics
NPI:1619908944
Name:KALRA, JAGJEET S (MD)
Entity type:Individual
Prefix:DR
First Name:JAGJEET
Middle Name:S
Last Name:KALRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 E MARCH LN STE C310
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-6683
Mailing Address - Country:US
Mailing Address - Phone:209-465-5731
Mailing Address - Fax:209-465-0230
Practice Address - Street 1:1801 E MARCH LN STE C310
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-6683
Practice Address - Country:US
Practice Address - Phone:209-465-5731
Practice Address - Fax:209-465-0230
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA444804207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A448040Medicaid
CAZZZ20945ZMedicare PIN
CAZZZ05893ZMedicare PIN
CA00A448040Medicaid