Provider Demographics
NPI:1457469561
Name:SANDHU, HARPREET SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:HARPREET
Middle Name:SINGH
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 1:200 N G ST
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-3410
Mailing Address - Country:US
Mailing Address - Phone:559-788-0818
Mailing Address - Fax:559-788-0150
Practice Address - Street 1:200 N G ST
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3410
Practice Address - Country:US
Practice Address - Phone:559-788-0818
Practice Address - Fax:559-788-0150
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51075174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A510751Medicaid
CA00A510750Medicare ID - Type Unspecified
CA00A510751Medicaid