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General NPI Number Information
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NPI Number | 1417026444
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Entity Type | Individual
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Provider Name | GURJIT SINGH DHALIWAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 2008 N GAREY AVE
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City | POMONA
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State | CA
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Zip | 91767-2722
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Country | US
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Telephone | 909-623-6131
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Fax | 909-865-9281
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Provider Business Mailing Address
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Address Line | 17905 SUNRISE DR
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-4790
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Country | US
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Telephone | 626-964-6208
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A36615
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License Number State | CA
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