Provider Demographics
NPI:1952370900
Name:SANGWAN, SEEMA (MD)
Entity Type:Individual
Prefix:DR
First Name:SEEMA
Middle Name:
Last Name:SANGWAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11126 LINDA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-4770
Mailing Address - Country:US
Mailing Address - Phone:650-799-2957
Mailing Address - Fax:
Practice Address - Street 1:877 W FREMONT AVE
Practice Address - Street 2:SUITE N1
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2315
Practice Address - Country:US
Practice Address - Phone:408-900-8077
Practice Address - Fax:844-965-9436
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78098207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A780980Medicaid
H73974Medicare UPIN
CA00A780980Medicaid