Healthcare Provider Details

I. General information

NPI: 1225316573
Provider Name (Legal Business Name): AMARPAUL SINGH BHATHAL M,D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 02/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11338 N BLUE SAGE AVE
FRESNO CA
93730-8846
US

IV. Provider business mailing address

11338 N BLUE SAGE AVE
FRESNO CA
93730-8846
US

V. Phone/Fax

Practice location:
  • Phone: 949-616-2105
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberA1333354
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: