Basic Information
| Provider Information | |||||||||
| NPI: | 1083631626 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIDHU | ||||||||
| FirstName: | SATWANT | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD MSPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7515 VAN NUYS BOULEVARD | ||||||||
| Address2: | 5TH FLOOR | ||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189474026 | ||||||||
| FaxNumber: | 8189898850 | ||||||||
| Practice Location | |||||||||
| Address1: | 7515 VAN NUYS BOULEVARD | ||||||||
| Address2: | 5TH FLOOR | ||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189474026 | ||||||||
| FaxNumber: | 8189898850 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083P0901X | A025138 | CA | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Public Health & General Preventive Medicine |
No ID Information.