Provider Demographics
NPI:1700047180
Name:AULAKH, AMARDEEP SINGH (DO)
Entity Type:Individual
Prefix:
First Name:AMARDEEP
Middle Name:SINGH
Last Name:AULAKH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25100
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-5100
Mailing Address - Country:US
Mailing Address - Phone:559-326-1222
Mailing Address - Fax:559-326-1230
Practice Address - Street 1:7130 N MILLBROOK AVE STE 100
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720
Practice Address - Country:US
Practice Address - Phone:559-326-1222
Practice Address - Fax:559-326-1230
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA245774207R00000X
CA20A11638207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPO1456186OtherMEDICARE RAILROAD
CA# CA129248OtherMEDICARE PTAN
CA20A11638OtherMEDICAL LICENSE