Provider Demographics
NPI:1801401211
Name:MATHUR, SACHIN KUMAR
Entity Type:Individual
Prefix:MR
First Name:SACHIN
Middle Name:KUMAR
Last Name:MATHUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10934 ELKWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-5286
Mailing Address - Country:US
Mailing Address - Phone:909-648-1763
Mailing Address - Fax:
Practice Address - Street 1:10934 ELKWOOD CIR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-5286
Practice Address - Country:US
Practice Address - Phone:909-648-1763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist