Sukhtaz Dhaliwal, PHARMD
Individual provider Active NPI Pharmacist · Patterson, CA
NPI 1558095026 · NPPES record last updated Feb 7, 2024
Key facts
- NPI
- 1558095026
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 85055 (CA)
- Practice address
- 1030 Sperry Ave
Patterson, CA 95363-9267 - Phone
- (209) 895-4420
- NPI assigned
- Jul 12, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85055 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Store California LLC | Past |
Accepting new patients | |
| Longs Drug Stores California LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 85055 | CA | Yes |
Addresses
Primary practice location
1030 Sperry Ave
Patterson, CA 95363-9267
Mailing address
1030 Sperry Ave
Patterson, CA 95363-9267
Other providers in Patterson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.