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General NPI Number Information
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NPI Number | 1174962369
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Entity Type | Individual
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Provider Name | SANDEEP SINGH JHAJJ M.D
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Gender | Male
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 940 ROYAL AVE UNIT 100
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City | MEDFORD
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State | OR
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Zip | 97504-6194
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Country | US
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Telephone | 541-732-8388
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3158
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City | PORTLAND
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State | OR
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Zip | 97208-3158
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Country | US
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Telephone | 541-732-8388
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 61340200
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MS204777
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | R73897
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License Number State | AZ
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