Provider Demographics
NPI:1689101578
Name:GRANDHE, SUNDEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNDEEP
Middle Name:
Last Name:GRANDHE
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 1:1111 E SPRUCE AVE STE 431
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3330
Mailing Address - Country:US
Mailing Address - Phone:559-450-5611
Mailing Address - Fax:559-450-7470
Practice Address - Street 1:1303 E HERNDON AVE STE 850
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3309
Practice Address - Country:US
Practice Address - Phone:559-450-4214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA165414207RH0002X, 174V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No174V00000XOther Service ProvidersClinical Ethicist