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NPI Code Detail

MEDICARE: SAND DERMATOLOGY PC

MEDICARE: SAND DERMATOLOGY PC
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
1207N00000XDermatology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11003158544OTHERCADERMATOLOGY

General Provider Information

NPI Number : 1558918441
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAND DERMATOLOGY PC
Provider Business Mailing Address
First Line : 3110 CHINO AVE STE 120
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-1294
Country : US
Telephone Number : 909-313-5111
Fax Number : 909-313-0959
Provider Business Practice Location Address
First Line : 3110 CHINO AVE STE 120
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-1294
Country : US
Telephone Number : 562-659-4492
Fax Number : 408-628-0747
Authorized Official
Title or Position : MD
Name : AMANDEEP SANDHU
Credential : MD
Telephone Number : 562-659-4492
Provider Enumeration Date : 08/25/2019
Last Update Date : 05/09/2026

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1750939153 — SAND DERMATOLOGY PC
Practice Location Address:
3110 CHINO AVE STE 120
CHINO HILLS, CA
91709-1294
Practice Phone: 909-313-5111
Practice Fax: 909-313-0959

Directions to “SAND DERMATOLOGY PC ” Practice Location

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