Provider Demographics
NPI:1558574467
Name:ROHINDER KAUR SANDHU MD INC
Entity Type:Organization
Organization Name:ROHINDER KAUR SANDHU MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROHINDER
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-450-0158
Mailing Address - Street 1:1725 ISABELLA WAY
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-9275
Mailing Address - Country:US
Mailing Address - Phone:909-450-0158
Mailing Address - Fax:909-593-0096
Practice Address - Street 1:255 E BONITA AVE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91769
Practice Address - Country:US
Practice Address - Phone:909-450-0158
Practice Address - Fax:909-593-0096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43131174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE50887Medicare UPIN
CAW21045Medicare UPIN
CAZZZ05423ZMedicare PIN