Provider Demographics
NPI:1740243328
Name:SANDHU, HARCHETAN SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:HARCHETAN
Middle Name:SINGH
Last Name:SANDHU
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 1:1488 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1795
Mailing Address - Country:US
Mailing Address - Phone:530-342-1310
Mailing Address - Fax:530-342-1327
Practice Address - Street 1:1488 EAST AVE STE 130
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1795
Practice Address - Country:US
Practice Address - Phone:530-342-1310
Practice Address - Fax:530-342-1327
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76840207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A768400OtherALL OTHER INS CARRIERS
CA00A768400Medicaid
CAZZZ031872Medicare ID - Type UnspecifiedGROUP ID
CA00A768400Medicaid
CA00A768400OtherALL OTHER INS CARRIERS