Provider Demographics
NPI:1497265565
Name:SNF SPECIALISTS MEDICAL CORPORATION
Entity Type:Organization
Organization Name:SNF SPECIALISTS MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GURPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:DHUGGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-864-1095
Mailing Address - Street 1:2300 HENRY AVE
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-1714
Mailing Address - Country:US
Mailing Address - Phone:707-864-1056
Mailing Address - Fax:707-864-1095
Practice Address - Street 1:1255 TRAVIS BLVD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-4801
Practice Address - Country:US
Practice Address - Phone:707-864-1056
Practice Address - Fax:707-864-1095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63219207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty