Provider Demographics
NPI:1235864539
Name:DHILLON, SUKHMANDER SINGH
Entity Type:Individual
Prefix:MR
First Name:SUKHMANDER
Middle Name:SINGH
Last Name:DHILLON
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 1:4300 ASHE ROAD # 111
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313
Mailing Address - Country:US
Mailing Address - Phone:661-501-1002
Mailing Address - Fax:661-501-1075
Practice Address - Street 1:4300 ASHE ROAD # 111
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313
Practice Address - Country:US
Practice Address - Phone:661-501-1002
Practice Address - Fax:661-501-1075
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA116942332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies