Provider Demographics
NPI:1255125266
Name:DHALIWAL, AJAYPAL SINGH
Entity type:Individual
Prefix:
First Name:AJAYPAL
Middle Name:SINGH
Last Name:DHALIWAL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 S KAREN AVE
Mailing Address - Street 2:
Mailing Address - City:KERMAN
Mailing Address - State:CA
Mailing Address - Zip Code:93630-2036
Mailing Address - Country:US
Mailing Address - Phone:559-567-7668
Mailing Address - Fax:
Practice Address - Street 1:184 S KAREN AVE
Practice Address - Street 2:
Practice Address - City:KERMAN
Practice Address - State:CA
Practice Address - Zip Code:93630-2036
Practice Address - Country:US
Practice Address - Phone:559-567-7668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA740951164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse