Provider Demographics
NPI:1316031461
Name:HUNDAL, TALMINDER SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:TALMINDER
Middle Name:SINGH
Last Name:HUNDAL
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 1:1401 SPANOS CT
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355
Mailing Address - Country:US
Mailing Address - Phone:209-525-3171
Mailing Address - Fax:209-525-3812
Practice Address - Street 1:1401 SPANOS COURT
Practice Address - Street 2:SUITE 106
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355
Practice Address - Country:US
Practice Address - Phone:209-525-3171
Practice Address - Fax:209-525-3812
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45102207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0256422Medicaid
CA0256422Medicaid
00A451020Medicare ID - Type Unspecified