Provider Demographics
NPI:1548876766
Name:SANDHU, TANIA (PHARMD)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:SANDHU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 FLORAL AVE
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662-2602
Mailing Address - Country:US
Mailing Address - Phone:559-896-7105
Mailing Address - Fax:
Practice Address - Street 1:2640 FLORAL AVE
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-2602
Practice Address - Country:US
Practice Address - Phone:559-896-7105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83270183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist