| Doctor Name: | JAGMOHAN THIARA |
| NPI Number: | 1073855714 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 21948 |
| Business Practice Address: | 1531 Plumas Ct Ste B-d Yuba City, CA - 959912966 |
| Business Phone Number: | 5307511900 |
| Business Fax Number: | 5307514901 |
| Mailing Address: | 1130 4th Ave, RIO OSO |
| State: | CA |
| Postal Code: | 956749656 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/20/2013 |
| NPI Last Update Date: | 04/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 21948 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |