Provider Demographics
NPI:1316012982
Name:MOHINDER P AHLUWALIA M D & TREVI AHLUWALIA M D INC A PROF CORP
Entity Type:Organization
Organization Name:MOHINDER P AHLUWALIA M D & TREVI AHLUWALIA M D INC A PROF CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHINDER
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:AHLUWALIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-242-4888
Mailing Address - Street 1:15982 QUANTICO RD STE #A
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307
Mailing Address - Country:US
Mailing Address - Phone:760-242-9577
Mailing Address - Fax:760-242-2213
Practice Address - Street 1:15982 QUANTICO RD STE #A
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307
Practice Address - Country:US
Practice Address - Phone:760-242-9577
Practice Address - Fax:760-242-2213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0334017Medicaid
A28617Medicare UPIN
CA00A384210Medicare ID - Type Unspecified