Provider Demographics
NPI:1407135940
Name:DEHAL, AHMED NOWAF (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:NOWAF
Last Name:DEHAL
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 1:9200 MILLIKEN AVE
Mailing Address - Street 2:4204
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5484
Mailing Address - Country:US
Mailing Address - Phone:912-541-2526
Mailing Address - Fax:
Practice Address - Street 1:9200 MILLIKEN AVE
Practice Address - Street 2:4204
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5484
Practice Address - Country:US
Practice Address - Phone:912-541-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program