Provider Demographics
NPI:1780885574
Name:AHLUWALIA, HARDEEP SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:HARDEEP
Middle Name:SINGH
Last Name:AHLUWALIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 659
Mailing Address - Street 2:OPERATION BLUE STAR
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94023-0659
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:659 FREMONT AVE
Practice Address - Street 2:OPERATION BLUE STAR
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-0659
Practice Address - Country:US
Practice Address - Phone:704-622-0532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA867072086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery