MEDICARE: DR. SIKANDER BAINS M.D.

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
1	207Q00000X	Family Medicine Physician	125.060186	IL

General Provider Information

NPI Number	:	1922377712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIKANDER BAINS M.D.

Provider Business Mailing Address
First Line	:	4849 RONSON CT
Second Line	:	STE 217
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1805
Country	:	US
Telephone Number	:	619-992-5330
Fax Number	:	858-759-8942

Provider Business Practice Location Address
First Line	:	4849 RONSON CT
Second Line	:	STE 217
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1805
Country	:	US
Telephone Number	:	619-992-5330
Fax Number	:	858-759-8942

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2011
Last Update Date	:	02/02/2017

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