Provider Demographics
NPI:1437962644
Name:SOPHIA SANDHU MD INC
Entity type:Organization
Organization Name:SOPHIA SANDHU MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-705-1700
Mailing Address - Street 1:1201 N CATALINA AVENUE
Mailing Address - Street 2:PO BOX 88
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-2166
Mailing Address - Country:US
Mailing Address - Phone:310-705-1700
Mailing Address - Fax:
Practice Address - Street 1:22330 HAWTHORNE BLVD STE F
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-2536
Practice Address - Country:US
Practice Address - Phone:310-705-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOPHIA SANDHU MD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty