Provider Demographics
NPI:1518998814
Name:DHILLON-ASHLEY, TINA J (MD)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:J
Last Name:DHILLON-ASHLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 N FINE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1528
Mailing Address - Country:US
Mailing Address - Phone:559-457-5650
Mailing Address - Fax:559-457-5695
Practice Address - Street 1:1945 N FINE AVE STE 100
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1528
Practice Address - Country:US
Practice Address - Phone:559-457-5650
Practice Address - Fax:559-457-5695
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.39095207V00000X
CAA77950207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A779500Medicaid
CA00A779500Medicaid
CA00A779500Medicare ID - Type Unspecified