Provider Demographics
NPI:1225325277
Name:SIDHU, INDARJIT KAUR (PHARMD)
Entity Type:Individual
Prefix:
First Name:INDARJIT
Middle Name:KAUR
Last Name:SIDHU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1559 MALTA DR
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-1131
Mailing Address - Country:US
Mailing Address - Phone:530-671-2315
Mailing Address - Fax:
Practice Address - Street 1:1021 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932-2839
Practice Address - Country:US
Practice Address - Phone:530-458-2494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35910183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist