Healthcare Provider Details

I. General information

NPI: 1932336930
Provider Name (Legal Business Name): GUNDEEP SEKHON MBBS, MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2009
Last Update Date: 05/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR RM HC 435 DEPARTMENT OF PSYCHIATRY
STANFORD CA
94305-2200
US

IV. Provider business mailing address

401 QUARRY ROAD DEPARTMENT OF PSYCHIATRY
STANFORD CA
94305-5717
US

V. Phone/Fax

Practice location:
  • Phone: 605-723-5948
  • Fax:
Mailing address:
  • Phone: 605-723-6948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA122563
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: