Provider Demographics
NPI:1003158544
Name:SANDHU, AMANDEEP SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDEEP
Middle Name:SINGH
Last Name:SANDHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1122 E LINCOLN AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-1908
Mailing Address - Country:US
Mailing Address - Phone:714-987-9880
Mailing Address - Fax:714-709-8998
Practice Address - Street 1:1122 E LINCOLN AVE STE 105
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-1908
Practice Address - Country:US
Practice Address - Phone:714-987-9880
Practice Address - Fax:714-709-8998
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA133186207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA133186OtherCALIFORNIA MEDICAL LICENSE
TXR1864OtherTEXAS MEDICAL LICENSE