Healthcare Provider Details

I. General information

NPI: 1417109067
Provider Name (Legal Business Name): JASHDEEP SINGH DHOOT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 TORRANCE BLVD STE A
TORRANCE CA
90503-5800
US

IV. Provider business mailing address

3475 TORRANCE BLVD STE A
TORRANCE CA
90503-5800
US

V. Phone/Fax

Practice location:
  • Phone: 310-370-3568
  • Fax:
Mailing address:
  • Phone: 310-370-3568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA111117
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberA111117
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: