Provider Demographics
NPI:1477932507
Name:JASBIR S SANDHU M D INC
Entity Type:Organization
Organization Name:JASBIR S SANDHU M D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASBIR
Authorized Official - Middle Name:S
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-945-0818
Mailing Address - Street 1:41324 12TH ST W
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1466
Mailing Address - Country:US
Mailing Address - Phone:661-945-0818
Mailing Address - Fax:
Practice Address - Street 1:41324 12TH ST W
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1466
Practice Address - Country:US
Practice Address - Phone:661-945-0818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-21
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty