Provider Demographics
NPI:1114715067
Name:RANDHAWA, SUNITA
Entity type:Individual
Prefix:
First Name:SUNITA
Middle Name:
Last Name:RANDHAWA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 E CIVIC CENTER DR APT 2080
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-0103
Mailing Address - Country:US
Mailing Address - Phone:916-541-5825
Mailing Address - Fax:
Practice Address - Street 1:20062 S ELLSWORTH RD STE 105
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-0350
Practice Address - Country:US
Practice Address - Phone:480-454-4375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath