Healthcare Provider Details
I. General information
NPI: 1053505420
Provider Name (Legal Business Name): MANVEEN SEKHON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/29/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2100 NAPA VALLEJO HWY
NAPA CA
94558-6234
US
IV. Provider business mailing address
1600 9TH ST ROOM 205 MAILSTOP 2-3
SACRAMENTO CA
95814-6404
US
V. Phone/Fax
- Phone: 707-253-5000
- Fax: 707-253-5513
- Phone: 916-654-2431
- Fax: 916-654-3186
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | A92841 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: