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Individual

HARSIMRAT SANDHU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3802 BROADWAY, SUITE B, EVERETT, WA 98201-5032
(425) 259-6665
(425) 259-6014
Mailing address
333 CORPORATE DR, STE 260, LADERA RANCH, CA 92694-2180
(949) 768-2988

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MD00030499
WA
2084P0800X
Psychiatry Physician
Primary
G78707
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
FHC 70042F
SANTA CRUZ COUNTY CA MEDI-CAL SITE #
CA
01
FHC 70044F
SANTA CRUZ COUNTY CA MEDI-CAL SITE #
CA
01
G78707
PHYSICIAN AND SURGEON#
CA
01
ZZZ91891Z
SANTA CRUZ COUNTY CA MEDICARE GROUP PTAN#
CA
01
ZZZ91892Z
SANTA CRUZ COUNTY CA MEDICARE GROUP PTAN#
CA
01
ZZZ92069Z
SANTA CRUZ COUNTY CA MEDICARE GROUP PTAN#
CA
Enumeration date
09/02/2006
Last updated
10/28/2021
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