Basic Information
Provider Information | |||||||||
NPI: | 1942531066 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SOHAL | ||||||||
FirstName: | JEETINDER | ||||||||
MiddleName: | SINGH | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 5040 | ||||||||
Address2: |   | ||||||||
City: | OROVILLE | ||||||||
State: | CA | ||||||||
PostalCode: | 959660040 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5305338500 | ||||||||
FaxNumber: | 5305328370 | ||||||||
Practice Location | |||||||||
Address1: | 2809 OLIVE HWY STE 220 | ||||||||
Address2: |   | ||||||||
City: | OROVILLE | ||||||||
State: | CA | ||||||||
PostalCode: | 959666133 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5305328181 | ||||||||
FaxNumber: | 5305388083 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/29/2010 | ||||||||
LastUpdateDate: | 02/21/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 02/21/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | A110878 | CA | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   |
ID Information
ID | Type | State | Issuer | Description | 00A1108780 | 01 | CA | BLUE SHIELD PIN # | OTHER | 1942531066 | 05 | CA |   | MEDICAID |