Provider Demographics
NPI:1376795468
Name:GHUMAN, SUDEEP KAUR (MD)
Entity Type:Individual
Prefix:
First Name:SUDEEP
Middle Name:KAUR
Last Name:GHUMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2767 OLIVE HWY
Mailing Address - Street 2:MEDICAL STAFF OFFICE / OROVILLE HOSPITAL
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-6118
Mailing Address - Country:US
Mailing Address - Phone:918-528-5268
Mailing Address - Fax:918-770-0058
Practice Address - Street 1:2809 OLIVE HWY STE 150
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6133
Practice Address - Country:US
Practice Address - Phone:530-532-8180
Practice Address - Fax:530-538-3145
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117886207R00000X, 207RH0003X
OH35.097419207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1376795468Medicaid
OHH015730Medicare PIN