Healthcare Provider Details

I. General information

NPI: 1720012883
Provider Name (Legal Business Name): INDERPREET SINGH SEKHON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 10/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9143 CEDAR RIDGE DR
GRANITE BAY CA
95746-7234
US

IV. Provider business mailing address

9143 CEDAR RIDGE DR
GRANITE BAY CA
95746-7234
US

V. Phone/Fax

Practice location:
  • Phone: 916-872-4919
  • Fax:
Mailing address:
  • Phone: 916-872-4919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number48567
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA106754
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: