Provider Demographics
NPI:1144718982
Name:SAHI, GURPREET SINGH
Entity type:Individual
Prefix:
First Name:GURPREET
Middle Name:SINGH
Last Name:SAHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 CAL OAK RD
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-9621
Mailing Address - Country:US
Mailing Address - Phone:530-534-1495
Mailing Address - Fax:530-534-1497
Practice Address - Street 1:465 CAL OAK RD
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-9621
Practice Address - Country:US
Practice Address - Phone:530-534-1495
Practice Address - Fax:530-534-1497
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-26
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78163183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA$$$$$$$$$Medicaid