Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | A104177 | CA |
NPI | 1083860787 |
---|---|
Provider Name | Kiranbir Kaur Dhillon Thiara |
First Address | Oakland, CA 94612-3466 |
Second Address | Sacramento, CA 95823-4671 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2008 |
Last Update Date | 26/02/2009 |