Navdeep Dhaliwal, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A76261 Issued in CA

Practice address

4700 Las Vegas Blvd N
Dept of Neurology. Mike O'Callaghan Federal Hospital
Nellis Afb, NV 89191-6600

Phone

(702) 653-3244

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Navdeep Dhaliwal, M.D. a Prof.Corp

  • Psychosomatic Medicine Physician
  • Stockton, CA
  • NPI 1700096567
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221955200000",
    "number": "1346322294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "address_2": "DEPT OF NEUROLOGY. MIKE O'CALLAGHAN FEDERAL HOSPITAL",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "address_2": "DEPT OF NEUROLOGY. MIKE O'CALLAGHAN FEDERAL HOSPITAL",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALIWAL",
        "first_name": "NAVDEEP",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2008-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A76261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A762610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Del Mundo, COTA
• William Dennis, M.D.
• Justen T Despain, DO
• Krisma Desportes
• Jenny Sue Dewalt, CNM
• Rebecca Rose Difabio, MD
• Gary T Dirisio, PHARM D
• Caleb Nance Dixon, DO
• DO Karen Worzel, LLC
• Jake Daniel Dodge, DO

• Neurology Physician in Nellis Afb, NV
• Providers in Nellis Afb, NV by specialty
• Neurology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.