| CASE NUMBER | I-200-24201-207656 |
| CASE STATUS | Certified |
| RECEIVED DATE | 7/19/2024 |
| DECISION DATE | 7/26/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | FAMILY PRACTICE PHYSICIAN |
| SOC CODE | 29-1215.00 |
| SOC TITLE | Family Medicine Physicians |
| FULL TIME POSITION | N |
| BEGIN DATE | 8/1/2024 |
| END DATE | 7/31/2026 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 1 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | TULARE FAMILY PRACTICE MEDICAL GROUP |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 1070 N. CHERRY STREET |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | TULARE |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 93274 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +15596863421 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | KAMBOJ |
| EMPLOYER POC FIRST NAME | PRADEEP |
| EMPLOYER POC MIDDLE NAME | KUMAR |
| EMPLOYER POC JOB TITLE | MANAGING PARTNER |
| EMPLOYER POC ADDRESS1 | 1070 N. CHERRY STREET |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | TULARE |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 93274 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +15596863421 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | PRADEKAMBOJ@GMAIL.COM |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | MENON |
| AGENT ATTORNEY FIRST NAME | PIA |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 6127 S. ELLIS AVE |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | Chicago |
| AGENT ATTORNEY STATE | IL |
| AGENT ATTORNEY POSTAL CODE | 60637 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +17087710584 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | piamenon@lawmenon.com |
| LAWFIRM NAME BUSINESS NAME | THE LAW OFFICE OF PIA MENON, PC |
| STATE OF HIGHEST COURT | IL |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1070 N. CHERRY STREET |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | TULARE |
| WORKSITE COUNTY | TULARE |
| WORKSITE STATE | CA |
| WORKSITE POSTAL CODE | 93274 |
| WAGE RATE OF PAY FROM | 140.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $133.74 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-01-08 |
