Healthcare Provider Details
I. General information
NPI: 1710089784
Provider Name (Legal Business Name): SHOBHA SEKHON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/01/2006
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
820 E ALMOND AVE
MADERA CA
93637-5603
US
IV. Provider business mailing address
820 E ALMOND AVE
MADERA CA
93637-5603
US
V. Phone/Fax
- Phone: 559-674-8787
- Fax: 559-674-3592
- Phone: 559-674-8787
- Fax: 559-674-3592
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | A043774 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: