Provider Demographics
NPI:1689605602
Name:SANDHU, NARINDER (MD)
Entity Type:Individual
Prefix:
First Name:NARINDER
Middle Name:
Last Name:SANDHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2737 WOODBERRY WAY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-4758
Mailing Address - Country:US
Mailing Address - Phone:916-368-2828
Mailing Address - Fax:916-368-2818
Practice Address - Street 1:2737 WOODBERRY WAY
Practice Address - Street 2:SUITE 107
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-4758
Practice Address - Country:US
Practice Address - Phone:916-368-2828
Practice Address - Fax:916-368-2818
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA056411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A564114Medicare ID - Type Unspecified