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General NPI Number Information
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NPI Number | 1699274464
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Entity Type | Organization
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Legal Business Name | SANDHU SURGERY CENTER LLC
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Dates
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Enumeration Date | 02/07/2018
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 41324 12TH ST W STE C
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City | PALMDALE
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State | CA
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Zip | 93551-1467
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Country | US
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Telephone | 661-945-0818
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Fax | 661-945-8095
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Provider Business Mailing Address
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Address Line | PO BOX 6980
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City | LANCASTER
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State | CA
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Zip | 93539-6980
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Country | US
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Telephone | 661-945-0818
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Fax | 661-945-8095
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Authorized Official
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Title or Position | PRESIDENT
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Name | JASBIR S SANDHU
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Credential | MD
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Telephone | 661-945-0818
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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