Provider Demographics
NPI:1477573012
Name:DHALIWAL, KAIL (MD)
Entity Type:Individual
Prefix:
First Name:KAIL
Middle Name:
Last Name:DHALIWAL
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 1:3200 21ST ST STE 301
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3108
Mailing Address - Country:US
Mailing Address - Phone:661-334-1958
Mailing Address - Fax:661-324-4095
Practice Address - Street 1:420 34TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2237
Practice Address - Country:US
Practice Address - Phone:661-327-1792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC42833207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C428330Medicaid
CAZZZ21366ZMedicare PIN
G24791Medicare UPIN
CAAW844ZMedicare PIN
CA00C428330Medicaid
CAAW844VMedicare PIN
CA00C428330Medicare PIN
CAZZZ21365ZMedicare PIN
CAZZZ21367ZMedicare PIN
CAAW844YMedicare PIN
CAZZZ15998ZMedicare PIN
CAZZZ34009ZMedicare PIN
CAAW844WMedicare PIN
CAAW844XMedicare PIN
CA050088509Medicare PIN
CACD4582Medicare PIN
CAZZZ15999ZMedicare PIN