Provider Demographics
NPI:1982929105
Name:SODHI-GAUR, AVNEET KAUR (MD)
Entity Type:Individual
Prefix:MRS
First Name:AVNEET
Middle Name:KAUR
Last Name:SODHI-GAUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:AVNEET
Other - Middle Name:KAUR
Other - Last Name:SODHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:450 N ROXBURY DR
Mailing Address - Street 2:FL 3
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4238
Mailing Address - Country:US
Mailing Address - Phone:661-206-9753
Mailing Address - Fax:661-206-8924
Practice Address - Street 1:44815 FIG AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-3144
Practice Address - Country:US
Practice Address - Phone:661-949-5955
Practice Address - Fax:661-206-8924
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA136814207W00000X
DC390200000X
MA390200000X
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB238970Medicare UPIN