Healthcare Provider Details

I. General information

NPI: 1447725361
Provider Name (Legal Business Name): VIKRAM SEHDEV CRT, RRT, RCP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2018
Last Update Date: 10/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13652 CANTARA ST
PANORAMA CITY CA
91402-5423
US

IV. Provider business mailing address

4648 GREENCREST WAY
PALMDALE CA
93551-1840
US

V. Phone/Fax

Practice location:
  • Phone: 818-375-2000
  • Fax:
Mailing address:
  • Phone: 661-466-3543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number35803
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: