Provider Demographics
NPI:1871504605
Name:HUNDAL, SARBJIT SINGH (MD)
Entity Type:Individual
Prefix:
First Name:SARBJIT
Middle Name:SINGH
Last Name:HUNDAL
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 1:39263 MISSION BLVD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3037
Mailing Address - Country:US
Mailing Address - Phone:510-796-4500
Mailing Address - Fax:510-796-4573
Practice Address - Street 1:39263 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-3037
Practice Address - Country:US
Practice Address - Phone:510-796-4500
Practice Address - Fax:510-796-4573
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34847207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A348470Medicaid
CA180039398OtherRAILROAD MEDICARE PROVIDER NUMBER
CAA27598Medicare UPIN
CA00A348470Medicaid
CA0798930001Medicare NSC