Provider Demographics
NPI:1912280173
Name:SANDHU, ELVIA RAMIREZ (PA)
Entity Type:Individual
Prefix:
First Name:ELVIA
Middle Name:RAMIREZ
Last Name:SANDHU
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15361 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-7608
Mailing Address - Country:US
Mailing Address - Phone:909-393-7171
Mailing Address - Fax:909-393-7676
Practice Address - Street 1:15361 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-7608
Practice Address - Country:US
Practice Address - Phone:909-393-7171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21847363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant