Provider Demographics
NPI:1093276586
Name:SANDHU, JEENA KAUR (MD)
Entity type:Individual
Prefix:DR
First Name:JEENA
Middle Name:KAUR
Last Name:SANDHU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 HIDDEN RANCH DR
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-4564
Mailing Address - Country:US
Mailing Address - Phone:805-416-3280
Mailing Address - Fax:
Practice Address - Street 1:2001 SANTA MONICA BLVD STE 480W
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2121
Practice Address - Country:US
Practice Address - Phone:310-954-9501
Practice Address - Fax:310-954-9502
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01090792A207N00000X
CAA198964207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology