Healthcare Provider Details

I. General information

NPI: 1700734381
Provider Name (Legal Business Name): MANDEEP DHILLON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10805 N MATUS AVE
FRESNO CA
93730-9722
US

IV. Provider business mailing address

10805 N MATUS AVE
FRESNO CA
93730-9722
US

V. Phone/Fax

Practice location:
  • Phone: 559-286-9110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF03260528
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: