MEDICARE: AMNEET VIRK DULAI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	A117190	CA

General Provider Information

NPI Number	:	1992911309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMNEET VIRK DULAI MD

Provider Business Mailing Address
First Line	:	PO BOX 28915
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93729-8915
Country	:	US
Telephone Number	:	559-253-2800
Fax Number	:	559-253-2808

Provider Business Practice Location Address
First Line	:	7082 N MAPLE AVE STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-8004
Country	:	US
Telephone Number	:	559-449-0331
Fax Number	:	559-449-0246

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	10/31/2014

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