Provider Demographics
NPI:1053746974
Name:SIDHU, DALJINDER (PHARMD)
Entity type:Individual
Prefix:
First Name:DALJINDER
Middle Name:
Last Name:SIDHU
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 1:8550 E KEIM DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-5815
Mailing Address - Country:US
Mailing Address - Phone:530-701-1130
Mailing Address - Fax:
Practice Address - Street 1:10707 W PEORIA AVE
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-4061
Practice Address - Country:US
Practice Address - Phone:623-974-3603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ020145183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist