Individual
JEEVANJOAT SANDHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
1904 RICHLAND AVE, CERES, CA 95307-4562
(510) 747-0513
Mailing address
733 MONIQUE CT, MODESTO, CA 95351-4535
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
38238
CA
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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