Provider Demographics
NPI:1902815350
Name:HUNDAL, KULJIT SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:KULJIT
Middle Name:SINGH
Last Name:HUNDAL
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 1:8 OAK PARK DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1414
Mailing Address - Country:US
Mailing Address - Phone:781-280-1699
Mailing Address - Fax:
Practice Address - Street 1:555 E HARDY ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4011
Practice Address - Country:US
Practice Address - Phone:310-419-8636
Practice Address - Fax:310-963-0403
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81082207P00000X
NMMD2015-0007207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A810820Medicaid
CAWA81082Medicare PIN
CAWA81082BMedicare PIN
CAI25679Medicare UPIN
CA00A810820Medicaid
CABE540XMedicare PIN
CAWA81082CMedicare PIN