Provider Demographics
NPI:1851856157
Name:SANDHU, BHAN SINGH
Entity Type:Individual
Prefix:
First Name:BHAN
Middle Name:SINGH
Last Name:SANDHU
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 1:2234 KENRY WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-5508
Mailing Address - Country:US
Mailing Address - Phone:650-534-6937
Mailing Address - Fax:650-873-2047
Practice Address - Street 1:2234 KENRY WAY
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-5508
Practice Address - Country:US
Practice Address - Phone:650-534-6937
Practice Address - Fax:650-873-2047
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1093298343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)