Healthcare Provider Details

I. General information

NPI: 1487975041
Provider Name (Legal Business Name): PRENEET KAUR DHILLON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PRENEET SOMAL M.D.

II. Dates (important events)

Enumeration Date: 06/17/2010
Last Update Date: 05/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 MARCONI AVE
SACRAMENTO CA
95821-5303
US

IV. Provider business mailing address

PO BOX 162532
SACRAMENTO CA
95816-2532
US

V. Phone/Fax

Practice location:
  • Phone: 916-485-6500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA110967
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA110967
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: