Healthcare Provider Details

I. General information

NPI: 1255599593
Provider Name (Legal Business Name): INDERPREET SINGH DHILLON M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 05/30/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 WINDRUSH WAY
LODI CA
95242-9743
US

IV. Provider business mailing address

2715 W KETTLEMAN LN STE 203
LODI CA
95242-9289
US

V. Phone/Fax

Practice location:
  • Phone: 209-642-9210
  • Fax: 209-671-6419
Mailing address:
  • Phone: 347-346-1299
  • Fax: 209-642-6419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA 112570
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: