Provider Demographics
NPI:1417372673
Name:HUNDAL, PARVINDER
Entity Type:Individual
Prefix:
First Name:PARVINDER
Middle Name:
Last Name:HUNDAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3098 G ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-2137
Mailing Address - Country:US
Mailing Address - Phone:209-385-3438
Mailing Address - Fax:209-385-3630
Practice Address - Street 1:3098 G ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-2137
Practice Address - Country:US
Practice Address - Phone:209-385-3438
Practice Address - Fax:209-385-3630
Is Sole Proprietor?:No
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist