Healthcare Provider Details
I. General information
NPI: 1144287186
Provider Name (Legal Business Name): SARABJIT SINGH SANDHU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/26/2006
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
359 SAN MIGUEL DR STE 210
NEWPORT BEACH CA
92660-7808
US
IV. Provider business mailing address
359 SAN MIGUEL DR STE 210
NEWPORT BEACH CA
92660-7808
US
V. Phone/Fax
- Phone: 949-642-7757
- Fax: 949-682-7502
- Phone: 949-642-7757
- Fax: 949-682-7502
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084F0202X |
| Taxonomy | Forensic Psychiatry Physician |
| License Number | A47774 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | A47774 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0805X |
| Taxonomy | Geriatric Psychiatry Physician |
| License Number | A47774 |
| License Number State | CA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | A47774 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: