Provider Demographics
NPI:1700766763
Name:MANN, SANDEEP SINGH
Entity type:Individual
Prefix:
First Name:SANDEEP
Middle Name:SINGH
Last Name:MANN
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 1:2075 W EL CAMINO AVE APT 688
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95833-1494
Mailing Address - Country:US
Mailing Address - Phone:530-845-1533
Mailing Address - Fax:
Practice Address - Street 1:3000 HARBISON DR
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-3909
Practice Address - Country:US
Practice Address - Phone:707-452-8119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist