Provider Demographics
NPI:1114038221
Name:DHILLON, HARPREET S (MD)
Entity Type:Individual
Prefix:DR
First Name:HARPREET
Middle Name:S
Last Name:DHILLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2868 PROSPECT PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-6065
Mailing Address - Country:US
Mailing Address - Phone:916-388-3532
Mailing Address - Fax:916-388-3533
Practice Address - Street 1:33077 ALVARADO NILES RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-3109
Practice Address - Country:US
Practice Address - Phone:510-248-1500
Practice Address - Fax:510-675-0846
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71150207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A711500Medicaid
CAA71150OtherMEDICAL LICENSE
CA00A711500Medicaid