Provider Demographics
NPI:1386730125
Name:SANDHU, TEJINDER S (MD)
Entity type:Individual
Prefix:
First Name:TEJINDER
Middle Name:S
Last Name:SANDHU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2570 JENSEN AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:CA
Mailing Address - Zip Code:93657-2269
Mailing Address - Country:US
Mailing Address - Phone:559-875-7149
Mailing Address - Fax:559-875-9661
Practice Address - Street 1:2570 JENSEN AVE STE 103
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:CA
Practice Address - Zip Code:93657-2269
Practice Address - Country:US
Practice Address - Phone:559-875-7149
Practice Address - Fax:559-875-9661
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33330207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A333300Medicaid
CA00A333300Medicaid
CA00A333302Medicare PIN