Provider Demographics
NPI:1659035152
Name:SAHOTA, SARBJIT SINGH
Entity Type:Individual
Prefix:
First Name:SARBJIT
Middle Name:SINGH
Last Name:SAHOTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2894 EVERGREEN CT
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:CA
Mailing Address - Zip Code:95334-9114
Mailing Address - Country:US
Mailing Address - Phone:209-202-9767
Mailing Address - Fax:
Practice Address - Street 1:1651 BELLEVUE RD
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-2608
Practice Address - Country:US
Practice Address - Phone:209-358-3304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84882183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist