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General NPI Number Information
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NPI Number | 1710743380
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Entity Type | Organization
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Legal Business Name | SUNDEEP GRANDHE MD CORPORATION
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 500 OLD RIVER RD STE 105
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City | BAKERSFIELD
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State | CA
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Zip | 93311-9505
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Country | US
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Telephone | 661-327-9300
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Fax | 661-327-9301
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Provider Business Mailing Address
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Address Line | 2012 NORWICH WAY
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City | BAKERSFIELD
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State | CA
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Zip | 93311-2910
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUNDEEP GRANDHE
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Credential | MD
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Telephone | 661-529-5558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) 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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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