Healthcare Provider Details

I. General information

NPI: 1386088060
Provider Name (Legal Business Name): HARSHARANDEEP SANGHERA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 06/19/2020
Certification Date: 06/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 N ORANGE GROVE AVE
POMONA CA
91767-3006
US

IV. Provider business mailing address

1880 N ORANGE GROVE AVE
POMONA CA
91767-3006
US

V. Phone/Fax

Practice location:
  • Phone: 909-630-7158
  • Fax: 909-630-7983
Mailing address:
  • Phone: 909-398-1550
  • Fax: 909-398-1488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code193200000X
TaxonomyMulti-Specialty Group
License NumberA140864
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA140864
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA140864
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: