Healthcare Provider Details

I. General information

NPI: 1184828402
Provider Name (Legal Business Name): ROOPINDER SANDHU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 S SAN VICENTE BLVD STE A3600
LOS ANGELES CA
90048-3311
US

IV. Provider business mailing address

4140 W 190TH ST
TORRANCE CA
90504-5513
US

V. Phone/Fax

Practice location:
  • Phone: 310-248-6679
  • Fax: 310-423-6795
Mailing address:
  • Phone: 310-967-1780
  • Fax: 866-991-4287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57006007
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberC170042
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: