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General NPI Number Information
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NPI Number | 1336429711
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Entity Type | Individual
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Provider Name | SONIA TANBIR BAJWA-DULAI
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Gender | Female
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 195 PAGE MILL RD STE 103
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City | PALO ALTO
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State | CA
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Zip | 94306-2073
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Country | US
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Telephone | 888-731-8994
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Fax |
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Provider Business Mailing Address
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Address Line | 410 PARK AVE
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City | WILMETTE
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State | IL
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Zip | 60091-2550
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Country | US
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Telephone | 888-731-8994
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A132228
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License Number State | CA
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