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General NPI Number Information
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NPI Number | 1124328273
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Entity Type | Organization
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Legal Business Name | SHIVINDER S. DEOL M.D., INC.
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Dates
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Enumeration Date | 10/22/2010
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Last Update Date | 09/16/2015
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Provider Practice Location Address
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Address Line | 4000 STOCKDALE HWY STE D
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City | BAKERSFIELD
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State | CA
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Zip | 93309-2059
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Country | US
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Telephone | 661-325-7452
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Fax | 661-325-7456
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Provider Business Mailing Address
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Address Line | 4000 STOCKDALE HWY STE D
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City | BAKERSFIELD
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State | CA
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Zip | 93309-2059
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Country | US
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Telephone | 661-325-7452
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Fax | 661-325-7456
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHIVINDER S DEOL
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Credential | M.D.
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Telephone | 661-325-7452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A37723
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License Number State | CA
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