Healthcare Provider Details

I. General information

NPI: 1003223215
Provider Name (Legal Business Name): AANCHAL SEKHON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2014
Last Update Date: 07/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22421 HESPERIAN BLVD
HAYWARD CA
94541-7010
US

IV. Provider business mailing address

22421 HESPERIAN BLVD
HAYWARD CA
94541-7010
US

V. Phone/Fax

Practice location:
  • Phone: 510-782-4161
  • Fax:
Mailing address:
  • Phone: 510-782-4161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number63643
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: