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General NPI Number Information
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NPI Number | 1700394608
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Entity Type | Individual
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Provider Name | MANDEEP K SIDHU
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Gender | Female
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Dates
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Enumeration Date | 01/14/2018
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 7005 N MILBURN AVE
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City | FRESNO
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State | CA
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Zip | 93722-2161
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Country | US
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Telephone | 559-603-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 1649 VAN NESS AVE
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City | FRESNO
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State | CA
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Zip | 93721-1128
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Country | US
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Telephone | 888-530-4415
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A179949
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License Number State | CA
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