Provider Demographics
NPI:1174061279
Name:PROMOJ,INC
Entity type:Organization
Organization Name:PROMOJ,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PROMOJ
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:LAKRA
Authorized Official - Suffix:
Authorized Official - Credentials:RCP
Authorized Official - Phone:424-477-5360
Mailing Address - Street 1:1254 W 8TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-2944
Mailing Address - Country:US
Mailing Address - Phone:424-477-5360
Mailing Address - Fax:424-477-5167
Practice Address - Street 1:1254 W 8TH ST APT 2
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-2944
Practice Address - Country:US
Practice Address - Phone:424-477-5360
Practice Address - Fax:424-477-5167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren