Healthcare Provider Details

I. General information

NPI: 1093893794
Provider Name (Legal Business Name): RABINDER S. SIDHU, M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 02/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7151 N CEDAR AVE SUITE #103
FRESNO CA
93720-3389
US

IV. Provider business mailing address

7151 N CEDAR AVE SUITE #103
FRESNO CA
93720-3389
US

V. Phone/Fax

Practice location:
  • Phone: 559-325-7775
  • Fax: 559-325-7505
Mailing address:
  • Phone: 559-325-7775
  • Fax: 559-325-7505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA42338
License Number StateCA

VIII. Authorized Official

Name: DR. RABINDER SIDHU
Title or Position: PRESIDENT
Credential: MD
Phone: 559-325-7775