MEDICARE: SURINDER P. DHILLON, 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	207R00000X	Internal Medicine Physician	00A406880	CA

General Provider Information

NPI Number	:	1619235611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURINDER P. DHILLON, M.D.

Provider Business Mailing Address
First Line	:	6079 N FRESNO ST STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-5276
Country	:	US
Telephone Number	:	559-438-1400
Fax Number	:	559-438-5360

Provider Business Practice Location Address
First Line	:	6079 N FRESNO ST STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-5276
Country	:	US
Telephone Number	:	559-438-1400
Fax Number	:	559-438-5360

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SURINDER P DHILLON
Credential	:	M.D.
Telephone Number	:	559-438-1400

Provider Enumeration Date	:	04/26/2012
Last Update Date	:	04/26/2012

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