Provider Demographics
NPI:1083717979
Name:GWALANI, TULSIDAS RAMESHBHAI (MD)
Entity Type:Individual
Prefix:
First Name:TULSIDAS
Middle Name:RAMESHBHAI
Last Name:GWALANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 MOWRY AVE
Mailing Address - Street 2:FREMONT PAIN TREATMENT CENTER
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536
Mailing Address - Country:US
Mailing Address - Phone:510-818-9237
Mailing Address - Fax:510-818-9222
Practice Address - Street 1:656 MOWRY AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-4113
Practice Address - Country:US
Practice Address - Phone:510-818-9237
Practice Address - Fax:510-818-9222
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76626208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine