Healthcare Provider Details

I. General information

NPI: 1316012982
Provider Name (Legal Business Name): MOHINDER P AHLUWALIA M D & TREVI AHLUWALIA M D INC A PROF CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16143 KOKANEE RD STE A
APPLE VALLEY CA
92307-1355
US

IV. Provider business mailing address

16143 KOKANEE RD STE A
APPLE VALLEY CA
92307-1355
US

V. Phone/Fax

Practice location:
  • Phone: 760-242-9577
  • Fax: 760-242-2213
Mailing address:
  • Phone: 760-242-9577
  • Fax: 760-242-2213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: SHERRY NELSON
Title or Position: BILLING MANAGER
Credential:
Phone: 760-242-9580