Healthcare Provider Details

I. General information

NPI: 1609455153
Provider Name (Legal Business Name): LOVEPREET DHILLON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 BIG HORN BLVD
ELK GROVE CA
95758-1240
US

IV. Provider business mailing address

6600 BRUCEVILLE RD
SACRAMENTO CA
95823-4671
US

V. Phone/Fax

Practice location:
  • Phone: 916-478-5100
  • Fax:
Mailing address:
  • Phone: 916-688-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number22666
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: