Provider Demographics
NPI:1164219952
Name:RANDHAWA, AMAN SINGH
Entity type:Individual
Prefix:
First Name:AMAN
Middle Name:SINGH
Last Name:RANDHAWA
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 1:725 PROVANCE ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-6364
Mailing Address - Country:US
Mailing Address - Phone:951-764-9195
Mailing Address - Fax:
Practice Address - Street 1:725 PROVANCE ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-6364
Practice Address - Country:US
Practice Address - Phone:951-764-9195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95034802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily