Provider Demographics
NPI:1144796095
Name:GHUMAN, SUKHJIT SINGH
Entity Type:Individual
Prefix:MR
First Name:SUKHJIT
Middle Name:SINGH
Last Name:GHUMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9097 E DESERT COVE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6276
Mailing Address - Country:US
Mailing Address - Phone:408-609-4200
Mailing Address - Fax:408-609-4233
Practice Address - Street 1:9097 E DESERT COVE AVE STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6276
Practice Address - Country:US
Practice Address - Phone:408-609-4200
Practice Address - Fax:408-609-4233
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center