Provider Demographics
NPI:1245388412
Name:POONIA, MOHINDER S (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHINDER
Middle Name:S
Last Name:POONIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7035 N CHESTNUT AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0352
Mailing Address - Country:US
Mailing Address - Phone:559-325-2000
Mailing Address - Fax:559-325-2021
Practice Address - Street 1:7035 N CHESTNUT AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0352
Practice Address - Country:US
Practice Address - Phone:559-325-2000
Practice Address - Fax:559-325-2021
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2012-06-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA36683207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A366830Medicaid
CA00A366830Medicaid