Provider Demographics
NPI:1275500068
Name:SANDHU, CHARANJIT (MD)
Entity Type:Individual
Prefix:
First Name:CHARANJIT
Middle Name:
Last Name:SANDHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SCRIPPS DR STE 208
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6207
Mailing Address - Country:US
Mailing Address - Phone:916-569-4400
Mailing Address - Fax:916-569-4435
Practice Address - Street 1:2 SCRIPPS DR STE 208
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6207
Practice Address - Country:US
Practice Address - Phone:916-569-4400
Practice Address - Fax:916-569-4435
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG11065Medicare UPIN
CAGR0085030Medicare ID - Type Unspecified
CAZZZ15804ZMedicare ID - Type Unspecified