Provider Demographics
NPI:1518495423
Name:SANGHA, RANDEEP KAUR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RANDEEP
Middle Name:KAUR
Last Name:SANGHA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4959 MARCONI AVE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-4112
Mailing Address - Country:US
Mailing Address - Phone:916-485-1144
Mailing Address - Fax:916-485-2454
Practice Address - Street 1:4959 MARCONI AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-4112
Practice Address - Country:US
Practice Address - Phone:916-485-1144
Practice Address - Fax:916-485-2454
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-23
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA69010OtherCALIFORNIA BOARD OF PHARMACY