Provider Demographics
NPI:1952432122
Name:SARBJIT SINGH HUNDAL
Entity Type:Organization
Organization Name:SARBJIT SINGH HUNDAL
Other - Org Name:MISSION VALLEY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARBJIT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:HUNDAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-796-4500
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34847261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASUR01190FMedicaid
CAZZZ27388ZMedicare PIN
CAA27598Medicare UPIN