Provider Demographics
NPI:1851645287
Name:SIDHU, AMARPREET KAUR (PHARM D)
Entity Type:Individual
Prefix:
First Name:AMARPREET
Middle Name:KAUR
Last Name:SIDHU
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3526 YORK LN
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-5821
Mailing Address - Country:US
Mailing Address - Phone:925-353-0945
Mailing Address - Fax:
Practice Address - Street 1:16858 GOLDEN VALLEY PARKWAY
Practice Address - Street 2:
Practice Address - City:LATHROP
Practice Address - State:CA
Practice Address - Zip Code:95330
Practice Address - Country:US
Practice Address - Phone:209-357-4820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66199183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist