Provider Demographics
NPI:1720012883
Name:SEKHON, INDERPREET SINGH (MD)
Entity Type:Individual
Prefix:
First Name:INDERPREET
Middle Name:SINGH
Last Name:SEKHON
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 1:9143 CEDAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-7234
Mailing Address - Country:US
Mailing Address - Phone:916-872-4919
Mailing Address - Fax:
Practice Address - Street 1:9143 CEDAR RIDGE DR
Practice Address - Street 2:
Practice Address - City:GRANITE BAY
Practice Address - State:CA
Practice Address - Zip Code:95746-7234
Practice Address - Country:US
Practice Address - Phone:916-872-4919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI48567207RN0300X
CAA106754207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIP00266289OtherMEDICARE RR
WI34802300Medicaid
I45592Medicare UPIN
WI34802300Medicaid