Provider Demographics
NPI:1457003931
Name:SIDHU, SATPAL SINGH
Entity Type:Individual
Prefix:
First Name:SATPAL SINGH
Middle Name:
Last Name:SIDHU
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 1:5090 N PRIMITIVO WAY APT 327
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8247
Mailing Address - Country:US
Mailing Address - Phone:559-293-8302
Mailing Address - Fax:
Practice Address - Street 1:5090 N PRIMITIVO WAY APT 327
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8247
Practice Address - Country:US
Practice Address - Phone:559-293-8302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7GCS310343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)