Healthcare Provider Details

I. General information

NPI: 1093645442
Provider Name (Legal Business Name): SONIA SANDHU OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3133 W MARCH LN STE 2020
STOCKTON CA
95219-2361
US

IV. Provider business mailing address

3133 W MARCH LN STE 2020
STOCKTON CA
95219-2361
US

V. Phone/Fax

Practice location:
  • Phone: 209-951-0820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36218TLG
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: