Healthcare Provider Details

I. General information

NPI: 1740119163
Provider Name (Legal Business Name): SURINDER SINGH AHLUWALIA SENIOR CARE PROVIDER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

672 KINGFISHER CT
MERCED CA
95340-8362
US

IV. Provider business mailing address

1691 JOE SILVA AVE
ATWATER CA
95301-9114
US

V. Phone/Fax

Practice location:
  • Phone: 925-852-4995
  • Fax: 204-633-0140
Mailing address:
  • Phone: 925-852-4995
  • Fax: 204-633-0140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number247209647
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: