Provider Demographics
NPI:1134236938
Name:TIWANA, AJITPAL SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:AJITPAL
Middle Name:SINGH
Last Name:TIWANA
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 1:2700 F ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1849
Mailing Address - Country:US
Mailing Address - Phone:661-325-5513
Mailing Address - Fax:661-325-3304
Practice Address - Street 1:2700 F ST STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-1849
Practice Address - Country:US
Practice Address - Phone:661-325-5513
Practice Address - Fax:661-325-3304
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42864261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A428640Medicare PIN
CAA88600Medicare UPIN