Healthcare Provider Details

I. General information

NPI: 1669402467
Provider Name (Legal Business Name): BIKRAMJIT S AHLUWALIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 02/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16143 KOKANEE RD SUITE C
APPLE VALLEY CA
92307-1382
US

IV. Provider business mailing address

16143 KOKANEE RD SUITE C
APPLE VALLEY CA
92307-1382
US

V. Phone/Fax

Practice location:
  • Phone: 760-242-6442
  • Fax: 760-242-9025
Mailing address:
  • Phone: 760-242-6442
  • Fax: 760-242-9025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberC52278
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: