Healthcare Provider Details

I. General information

NPI: 1154006401
Provider Name (Legal Business Name): D DHILLON AND D CHANDRA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 PLUMAS ST STE 1300A
YUBA CITY CA
95991-3400
US

IV. Provider business mailing address

1215 PLUMAS ST STE 1300A
YUBA CITY CA
95991-3400
US

V. Phone/Fax

Practice location:
  • Phone: 530-870-8892
  • Fax: 530-870-8352
Mailing address:
  • Phone: 530-870-8892
  • Fax: 530-870-8352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: KAYLA BRENNAN
Title or Position: BILLING/CREDENTIALING MANAGER
Credential:
Phone: 626-264-3274