Basic Information
Provider Information
NPI: 1801128806
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NENSEY
FirstName: AMRITA
MiddleName: SINGH
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SACHDEVA
OtherFirstName: AMRITA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 3400 DTA DR
Address2: ATTN: CREDENTIALING/PAYER ENROLLMENT
City: RANCHO CORDOVA
State: CA
PostalCode: 956707956
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 18460 ROSCOE BLVD FL 3
Address2:  
City: NORTHRIDGE
State: CA
PostalCode: 913254107
CountryCode: US
TelephoneNumber: 8188855480
FaxNumber: 8189931917
Other Information
ProviderEnumerationDate: 02/02/2010
LastUpdateDate: 04/09/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/09/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000XC150371CAY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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