Provider Demographics
NPI:1790718138
Name:SACHDEVA, KULVEEN (MD)
Entity Type:Individual
Prefix:
First Name:KULVEEN
Middle Name:
Last Name:SACHDEVA
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 1:5401 NORRIS CANYON RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-5406
Mailing Address - Country:US
Mailing Address - Phone:925-866-7252
Mailing Address - Fax:925-866-7255
Practice Address - Street 1:5401 NORRIS CANYON RD STE 110
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-5406
Practice Address - Country:US
Practice Address - Phone:925-866-7252
Practice Address - Fax:925-866-7255
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43755204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A437550OtherBLUE SHIELD
CA00A437550Medicare PIN
CAE91916Medicare UPIN
CA00A437550OtherBLUE SHIELD