Healthcare Provider Details

I. General information

NPI: 1497916647
Provider Name (Legal Business Name): VIJAY SINGH SEKHON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 03/26/2020
Certification Date: 03/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 EUREKA AVE
RENO NV
89512-3425
US

IV. Provider business mailing address

PO BOX 22995
PASADENA CA
91185-0001
US

V. Phone/Fax

Practice location:
  • Phone: 775-323-5083
  • Fax: 775-785-8731
Mailing address:
  • Phone: 775-323-5083
  • Fax: 775-785-8731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number15744
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2009008007
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: