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NPI Code Detail

MEDICARE: DAVINDER-DEEP BHANGOO

MEDICARE: DAVINDER-DEEP BHANGOO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA64648CA

General Provider Information

NPI Number : 1154164820
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVINDER-DEEP BHANGOO
Provider Business Mailing Address
First Line : 6703 GUADALUPE LN
Second Line :
City : STOCKTON
State : CA
Zip : 95219-8838
Country : US
Telephone Number : 559-301-5201
Fax Number :
Provider Business Practice Location Address
First Line : 2315 STOCKTON BLVD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-2201
Country : US
Telephone Number : 916-734-3229
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2024
Last Update Date : 02/04/2026

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Directions to “ DAVINDER-DEEP BHANGOO ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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