Healthcare Provider Details

I. General information

NPI: 1144457979
Provider Name (Legal Business Name): KARAMJEET SINGH SANDHU M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2009
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 DUARTE RD DEPT OF HEMATOLOGY & HEMATOPOIETIC CELL TRANSPLANTATION
DUARTE CA
91010-3012
US

IV. Provider business mailing address

PO BOX 512185
LOS ANGELES CA
90051-0185
US

V. Phone/Fax

Practice location:
  • Phone: 626-256-4673
  • Fax: 626-301-8116
Mailing address:
  • Phone: 626-256-4673
  • Fax: 626-218-5310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA132945
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberA132945
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: