MEDICARE: DR. AMARPAUL SINGH BHATHAL M,D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		OH
2	261Q00000X	Clinic/Center	A1333354	CA

General Provider Information

NPI Number	:	1225316573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMARPAUL SINGH BHATHAL M,D

Provider Business Mailing Address
First Line	:	11338 N BLUE SAGE AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93730-8846
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11338 N BLUE SAGE AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93730-8846
Country	:	US
Telephone Number	:	949-616-2105
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2011
Last Update Date	:	02/23/2017

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