Healthcare Provider Details

I. General information

NPI: 1386750487
Provider Name (Legal Business Name): SURINDER P DHILLON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40886 GOODWIN WAY
MADERA CA
93636-9900
US

IV. Provider business mailing address

7523 N ANTIOCH AVE
FRESNO CA
93722-2130
US

V. Phone/Fax

Practice location:
  • Phone: 559-603-6000
  • Fax: 559-603-6100
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number00A406880
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: