Provider Demographics
NPI:1215265947
Name:BAJWA, AMANDEEP KAUR (MD)
Entity type:Individual
Prefix:MRS
First Name:AMANDEEP
Middle Name:KAUR
Last Name:BAJWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:916-816-1486
Mailing Address - Fax:
Practice Address - Street 1:550 W RANCH VIEW DR STE 3000
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5397
Practice Address - Country:US
Practice Address - Phone:916-409-1400
Practice Address - Fax:916-409-1499
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC146167207Q00000X
PAMD446429207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine