Individual
KULDIP SANDHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6555 COYLE AVE, SUITE 341, CARMICHAEL, CA 95608-0302
(916) 536-2596
(916) 536-2498
Mailing address
3400 DATA DR, PHYSICIAN SUPPORT SERVICES, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A37098
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A37098
CA MEDICAL LICENSE
CA
01
—
ZZZ13841Z
MEDICARE ID - ROSEVILLE
CA
01
—
ZZZ13842Z
MEDICARE ID - CARMICHAEL
CA
01
—
ZZZ29516Z
MEDICARE ID - LINCOLN
CA
01
—
ZZZ43589Z
MEDICARE SUBMITTER ID
CA
Enumeration date
02/07/2007
Last updated
12/31/2014
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