Provider Demographics
NPI:1780075564
Name:DHILLON, PAWANJIT KAUR (NP)
Entity type:Individual
Prefix:
First Name:PAWANJIT
Middle Name:KAUR
Last Name:DHILLON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 PASEO ROBLES AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MARTIN
Mailing Address - State:CA
Mailing Address - Zip Code:95046-9706
Mailing Address - Country:US
Mailing Address - Phone:408-500-9650
Mailing Address - Fax:
Practice Address - Street 1:2915 PASEO ROBLES AVE
Practice Address - Street 2:
Practice Address - City:SAN MARTIN
Practice Address - State:CA
Practice Address - Zip Code:95046-9706
Practice Address - Country:US
Practice Address - Phone:408-500-9650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-14
Last Update Date:2015-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA536564163W00000X
CA95001567363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse