Provider Demographics
NPI:1336156728
Name:DHILLON, GURMEJ SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:GURMEJ
Middle Name:SINGH
Last Name:DHILLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GURMEJ
Other - Middle Name:SINGH
Other - Last Name:DHILLON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 25880
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-5880
Mailing Address - Country:US
Mailing Address - Phone:559-431-8900
Mailing Address - Fax:559-431-4367
Practice Address - Street 1:6069 N 1ST ST STE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5467
Practice Address - Country:US
Practice Address - Phone:559-431-8900
Practice Address - Fax:559-431-4367
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62406207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0089960Medicaid
CAZZZ02137ZOtherBLUE SHIELD PROVIDER ID
CAZZZ20843ZMedicare ID - Type Unspecified
CAF64090Medicare UPIN