MEDICARE: SUKHRAJ SINGH BAINS MD

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	2084P0800X	Psychiatry Physician	A204590	CA

General Provider Information

NPI Number	:	1720667470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUKHRAJ SINGH BAINS MD

Provider Business Mailing Address
First Line	:	777 DAVIS ST
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94577-6923
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 DAVIS ST
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94577-6923
Country	:	US
Telephone Number	:	510-626-2745
Fax Number	:

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

Provider Enumeration Date	:	04/07/2021
Last Update Date	:	12/30/2025

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