Provider Demographics
NPI:1699823872
Name:SANDHU, NARINDERPAL S (PAC)
Entity type:Individual
Prefix:MR
First Name:NARINDERPAL
Middle Name:S
Last Name:SANDHU
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 E OMAHA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2167
Mailing Address - Country:US
Mailing Address - Phone:559-431-9230
Mailing Address - Fax:
Practice Address - Street 1:5043 E KINGS CANYON RD
Practice Address - Street 2:#101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-3935
Practice Address - Country:US
Practice Address - Phone:559-455-1500
Practice Address - Fax:559-253-1302
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA18655363A00000X
CANP 16595363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant