Healthcare Provider Details

I. General information

NPI: 1295964781
Provider Name (Legal Business Name): YADWINDER S DHILLON MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 03/29/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 S DOBSON RD STE B122
MESA AZ
85202-4741
US

IV. Provider business mailing address

1450 S DOBSON RD STE B122
MESA AZ
85202-4741
US

V. Phone/Fax

Practice location:
  • Phone: 480-580-2001
  • Fax:
Mailing address:
  • Phone: 602-314-4432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YADWINDER SINGH DHILLON
Title or Position: CEO
Credential: MD
Phone: 602-314-4432