Provider Demographics
NPI:1679210637
Name:SANDHU, SANDEEP SINGH (MBCHB)
Entity Type:Individual
Prefix:DR
First Name:SANDEEP
Middle Name:SINGH
Last Name:SANDHU
Suffix:
Gender:M
Credentials:MBCHB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 W 190TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5513
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8635 W 3RD ST STE 1070W
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-6137
Practice Address - Country:US
Practice Address - Phone:310-423-4256
Practice Address - Fax:310-423-4711
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ111962207V00000X
CAA183503208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology