Healthcare Provider Details

I. General information

NPI: 1629235916
Provider Name (Legal Business Name): AMANJIT SEKHON ATWAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANJIT SEKHON MD

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 05/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST STE 1600
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

4860 Y ST STE 1600
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-3630
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA106457
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: