Provider Demographics
NPI:1386739613
Name:GURMIT S SANDHU LLC
Entity type:Organization
Organization Name:GURMIT S SANDHU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GURMIT
Authorized Official - Middle Name:S
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-831-6484
Mailing Address - Street 1:9222 S SHANNON DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-3527
Mailing Address - Country:US
Mailing Address - Phone:480-831-6484
Mailing Address - Fax:
Practice Address - Street 1:1400 S DOBSON RD
Practice Address - Street 2:BANNER DESERT MED CENTER
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4707
Practice Address - Country:US
Practice Address - Phone:480-512-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9611207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty