Provider Demographics
NPI:1821020140
Name:BHULLAR, NARINDER RAJ (MD)
Entity Type:Individual
Prefix:
First Name:NARINDER
Middle Name:RAJ
Last Name:BHULLAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAJ
Other - Middle Name:SIGN
Other - Last Name:BHULLAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:64 ASPEN WAY
Mailing Address - Street 2:STE. 101
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-3084
Mailing Address - Country:US
Mailing Address - Phone:831-786-1660
Mailing Address - Fax:831-786-1663
Practice Address - Street 1:64 ASPEN WAY
Practice Address - Street 2:STE. 101
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3084
Practice Address - Country:US
Practice Address - Phone:831-786-1660
Practice Address - Fax:831-786-1663
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA690292084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A690290Medicaid
CAH53716Medicare UPIN
CA00A690290Medicare ID - Type Unspecified
CA00A690290Medicaid