Healthcare Provider Details

I. General information

NPI: 1578164422
Provider Name (Legal Business Name): SWAPANPREET KAUR SANDHU OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 N CHERRY ST
TULARE CA
93274-2251
US

IV. Provider business mailing address

1618 E CALDWELL AVE
VISALIA CA
93292-9228
US

V. Phone/Fax

Practice location:
  • Phone: 559-686-4766
  • Fax: 559-686-2016
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618002936
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT35056
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: