Organization Active NPI

Jasbir S Sandhu M D Inc

  • Specialist
  • Palmdale, CA
National Provider Identifier
1477932507
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
JASBIR S SANDHU M D INC
Practice address
41324 12TH St W
Palmdale, CA 93551-1466
Phone
(661) 945-0818
NPI assigned
May 21, 2015
Last updated
Oct 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jasbir S Sandhu, M.D.NPI 1396789970
Title
President
Phone
(661) 945-0818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

41324 12TH St W
Palmdale, CA 93551-1466

Mailing address

41324 12TH St W
Palmdale, CA 93551-1466
Phone (661) 945-0818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150625001695 CA Part B Supplier - Clinic/Group Practice 5395056733 Receives reassigned benefits from 3 practitioners
Practice locations: California City, CA; Tehachapi, CA; Palmdale, CA; Ridgecrest, CA

National Provider Directory

National Provider Directory

Locations

41324 12th St W
Ste B
Palmdale, CA 93551
Phone 6619450818103

41324 12th St W
Ste C
Palmdale, CA 93551

41324 12th St W
Palmdale, CA 93551

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1477932507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41324 12TH ST W",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511466",
            "telephone_number": "661-945-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41324 12TH ST W",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511466",
            "telephone_number": "661-945-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASBIR S SANDHU M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-21",
        "last_updated": "2016-10-27",
        "status": "A",
        "authorized_official_last_name": "SANDHU",
        "authorized_official_first_name": "JASBIR",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-945-0818",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.