Healthcare Provider Details

I. General information

NPI: 1144097478
Provider Name (Legal Business Name): MADSON HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2023
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 STONERIDGE MALL RD FL COMMONS3
PLEASANTON CA
94588-3242
US

IV. Provider business mailing address

6200 STONERIDGE MALL RD FL COMMONS3
PLEASANTON CA
94588-3242
US

V. Phone/Fax

Practice location:
  • Phone: 925-474-4176
  • Fax: 559-765-0045
Mailing address:
  • Phone: 925-474-4176
  • Fax: 559-765-0045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. RAVI SANDHU
Title or Position: OWNER/PRESIDENT
Credential: EMHA
Phone: 925-474-4176