Healthcare Provider Details

I. General information

NPI: 1811928542
Provider Name (Legal Business Name): DATAR SINGH SODHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 S ORANGE AVE FL 1
WEST COVINA CA
91790-2662
US

IV. Provider business mailing address

741 S ORANGE AVE FL 1
WEST COVINA CA
91790-2662
US

V. Phone/Fax

Practice location:
  • Phone: 626-960-7117
  • Fax: 626-813-1038
Mailing address:
  • Phone: 626-960-7117
  • Fax: 626-813-1038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA34032
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberA34032
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA34032
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: