Provider Demographics
NPI:1356429161
Name:DHUGGA, GURPREET S (MD)
Entity type:Individual
Prefix:
First Name:GURPREET
Middle Name:S
Last Name:DHUGGA
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 1:5030 BUSINESS CENTER DR
Mailing Address - Street 2:STE # 130
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-6874
Mailing Address - Country:US
Mailing Address - Phone:707-864-1056
Mailing Address - Fax:
Practice Address - Street 1:5030 BUSINESS CENTER DR
Practice Address - Street 2:STE # 130
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-6874
Practice Address - Country:US
Practice Address - Phone:707-864-1056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63219207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A632190Medicaid
G81715Medicare UPIN
CA00A632190Medicaid