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NPI 1447754023

NPI 1447754023 : TARIN SINGH DHALIWAL MD : NOVATO, CA

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General NPI Number Information
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    NPI Number           |    1447754023
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    Entity Type          |    Individual 
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    Provider Name        |    TARIN SINGH DHALIWAL MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/20/2018
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    Last Update Date     |    09/23/2021
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Provider Practice Location Address
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    Address Line         |    101 ROWLAND WAY 
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    City                 |    NOVATO
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    State                |    CA
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    Zip                  |    94945-5008
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    Country              |    US
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    Telephone            |    415-878-7200
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    Fax                  |    415-369-1387
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Provider Business Mailing Address
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    Address Line         |    325 DISTEL CIR 
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    City                 |    LOS ALTOS
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    State                |    CA
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    Zip                  |    94022-1408
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    Country              |    US
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    Telephone            |    415-878-7200
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    Fax                  |    415-369-1387
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    A164079
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    License Number State |    CA
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