Healthcare Provider Details

I. General information

NPI: 1134236938
Provider Name (Legal Business Name): AJITPAL SINGH TIWANA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 01/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 F ST STE 100
BAKERSFIELD CA
93301-1849
US

IV. Provider business mailing address

2700 F ST STE 100
BAKERSFIELD CA
93301-1849
US

V. Phone/Fax

Practice location:
  • Phone: 661-325-5513
  • Fax: 661-325-3304
Mailing address:
  • Phone: 661-325-5513
  • Fax: 661-325-3304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberA42864
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: