=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487802898
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DHARAMPAL S JOHAL M D INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/28/2008
-----------------------------------------------------
Last Update Date | 12/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7011 N HOWARD ST STE 201
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93720-2955
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-431-2525
-----------------------------------------------------
Fax | 559-446-1500
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 26297
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93729-6297
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-431-2525
-----------------------------------------------------
Fax | 559-446-1500
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. DHARAMPAL S JOHAL
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 559-431-2525
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | A056018
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------