Healthcare Provider Details

I. General information

NPI: 1578473955
Provider Name (Legal Business Name): AMRITPREET BHANDAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 OAKDALE RD STE E
MODESTO CA
95355-2257
US

IV. Provider business mailing address

2328 STEINBECK DR
MODESTO CA
95356-9397
US

V. Phone/Fax

Practice location:
  • Phone: 209-523-4932
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number92934
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: