Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A615370 | CA |
N | 111NI0900X | Internist | A615370 | CA |
N | 207RC0200X | Critical Care Medicine | A615370 | CA |
NPI | 1063419364 |
---|---|
Provider Name | Dr. Pardeep Singh Bhullar |
First Address | Fresno, CA 93710-5236 |
Second Address | Fresno, CA 93710-5236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 15/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A615370 | (05) | CA |
G82270 | (02) | CA |