Provider Demographics
NPI:1548641152
Name:G SEKHON, A PC
Entity type:Organization
Organization Name:G SEKHON, A PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GURSIMRAT
Authorized Official - Middle Name:K
Authorized Official - Last Name:SEKHON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:209-594-0485
Mailing Address - Street 1:9307 LAGUNA SPRINGS DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7836
Mailing Address - Country:US
Mailing Address - Phone:916-691-1650
Mailing Address - Fax:916-691-0976
Practice Address - Street 1:3031 W MARCH LN STE 328
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-6562
Practice Address - Country:US
Practice Address - Phone:209-594-0485
Practice Address - Fax:209-594-0720
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:G SEKHON, A PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-10
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50820332BC3200X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty