Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A133186 | CA |
NPI | 1003158544 |
---|---|
Provider Name | Dr. Amandeep Singh Sandhu |
First Address | Chino Hills, CA 91709-1294 |
Second Address | Chino Hills, CA 91709-1294 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2013 |
Last Update Date | 02/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A133186 | CALIFORNIA MEDICAL LICENSE (01) | CA |
R1864 | TEXAS MEDICAL LICENSE (01) | TX |