Provider Demographics
NPI:1598827396
Name:SIDHU, GURCHARAN SINGH (MD)
Entity Type:Individual
Prefix:MR
First Name:GURCHARAN
Middle Name:SINGH
Last Name:SIDHU
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 1:6700 N FIRST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710
Mailing Address - Country:US
Mailing Address - Phone:559-463-0450
Mailing Address - Fax:559-436-0454
Practice Address - Street 1:6700 N FIRST
Practice Address - Street 2:SUITE 111
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:559-436-0450
Practice Address - Fax:559-436-0454
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A38687207R00000X, 207RP1001X
CAA38687207RC0200X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A386871Medicaid
CA110004599OtherMC RAILROAD
CA110004599OtherMC RAILROAD
A28698Medicare UPIN