Provider Demographics
NPI:1386648715
Name:SAINI, SUNIL KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:KUMAR
Last Name:SAINI
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 1:600 N MOUNTAIN AVE
Mailing Address - Street 2:STE B100
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4359
Mailing Address - Country:US
Mailing Address - Phone:909-931-7947
Mailing Address - Fax:909-937-1771
Practice Address - Street 1:600 N MOUNTAIN AVE
Practice Address - Street 2:STE B100
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4359
Practice Address - Country:US
Practice Address - Phone:909-931-7947
Practice Address - Fax:909-937-1771
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
CAG83756174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH10815Medicare UPIN
CAZZZ29590ZMedicare ID - Type Unspecified