Provider Demographics
NPI:1275771917
Name:DATAR S. SODHI, M.D.,INC.
Entity Type:Organization
Organization Name:DATAR S. SODHI, M.D.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DATAR
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:SODHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-814-1177
Mailing Address - Street 1:741 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2662
Mailing Address - Country:US
Mailing Address - Phone:626-814-1177
Mailing Address - Fax:
Practice Address - Street 1:741 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2662
Practice Address - Country:US
Practice Address - Phone:626-814-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34032207R00000X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A340320Medicaid
CACN412AMedicare PIN