Individual
DIP S. SIDHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-3910
Mailing address
393 E WALNUT ST, 3RD FLOOR PHR SYSTEMS, PASADENA, CA 91188-0001
(000) 000-0000
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
A29814
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A298140
—
CA
Enumeration date
01/08/2007
Last updated
11/30/2007
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