MEDICARE: DR. VARINDER SINGH PHANGUREH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0129X	Vascular Surgery Physician	A134831	CA

General Provider Information

NPI Number	:	1487972592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VARINDER SINGH PHANGUREH M.D.

Provider Business Mailing Address
First Line	:	13851 E 14TH ST STE 202
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94578-2627
Country	:	US
Telephone Number	:	510-347-4700
Fax Number	:	510-347-4712

Provider Business Practice Location Address
First Line	:	13851 E 14TH ST STE 202
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94578-2627
Country	:	US
Telephone Number	:	510-347-4700
Fax Number	:	510-347-4712

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2010
Last Update Date	:	02/25/2025

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