Individual provider Active NPI

Jasneet Dhillon Kullar, M.D.

  • Internal Medicine Physician
  • Mountain View, CA
National Provider Identifier
1639415870
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A125656 Issued in CA
Practice address
1674 N Shoreline Blvd
Mountain View, CA 94043-1374
Phone
(888) 201-1937
NPI assigned
Dec 17, 2012
Last updated
May 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A125656 CA Primary

Addresses

Primary practice location

1674 N Shoreline Blvd
Mountain View, CA 94043-1374

Mailing address

1674 N Shoreline Blvd
Mountain View, CA 94043-1374
Phone (888) 201-1937

Other identifiers 1

IdentifierTypeStateIssuer
1639415870MedicaidUT

Other names 1

  • Jasneet Dhillon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150204001273 CA Practitioner - Internal Medicine 8527293166 Reassigns benefits to 1 organization
I20230717000964 TX Practitioner - Internal Medicine 8527293166

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6069 N 1St St
Suite 103
Fresno, CA 93710-5467

95 3Rd St
San Francisco, CA 94103-3103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A125656CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fresno Medical Center Inc Internal Medicine CurrentSince Aug 22, 2023 Accepting new patients
Santa Cruz Medical Clinic, Inc Past Accepting new patients
1Lab Inc. PastSince Aug 22, 2023 Accepting new patients

Locations

6069 N 1st St
Ste 103
Fresno, CA 93710
Phone (559) 431-1228

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1639415870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1674 N SHORELINE BLVD",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940431374",
            "telephone_number": "888-201-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1674 N SHORELINE BLVD",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940431374",
            "telephone_number": "888-201-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULLAR",
        "first_name": "JASNEET",
        "middle_name": "DHILLON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-17",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A125656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639415870",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASNEET",
            "last_name": "DHILLON",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.