Healthcare Provider Details

I. General information

NPI: 1255485900
Provider Name (Legal Business Name): SIMARJIT K. DHALIWAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SIMAR K DHALIWAL

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 TELEGRAPH AVE
BERKELEY CA
94705-2017
US

IV. Provider business mailing address

2905 TELEGRAPH AVE
BERKELEY CA
94705-2017
US

V. Phone/Fax

Practice location:
  • Phone: 510-841-4525
  • Fax: 510-848-9970
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA95670
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: