Organization Active NPI

Navdeep Dhaliwal, M.D. a Prof.Corp

  • Psychosomatic Medicine Physician
  • Stockton, CA
National Provider Identifier
1700096567
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychosomatic Medicine PhysicianTaxonomy code 2084P0015X
Legal business name
NAVDEEP DHALIWAL, M.D. A PROF.CORP
Practice address
2626 N California St Ste F
Stockton, CA 95204-5500
Phone
(209) 462-9900
Fax
(209) 462-9909
NPI assigned
May 23, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Navdeep Dhaliwal, M.D.NPI 1346322294
Title
President
Phone
(209) 462-9900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychosomatic Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0015X Primary

Addresses

Primary practice location

2626 N California St Ste F
Stockton, CA 95204-5500

Mailing address

2626 N California St Ste F
Stockton, CA 95204-5500
Phone (209) 462-9900

Other identifiers 1

IdentifierTypeStateIssuer
6430436MedicaidCA

National Provider Directory

National Provider Directory

Locations

2626 N California St
Ste F
Stockton, CA 95204
Phone (209) 462-9100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700096567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 N CALIFORNIA ST STE F",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045500",
            "telephone_number": "209-462-9900",
            "fax_number": "209-462-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 N CALIFORNIA ST STE F",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045500",
            "telephone_number": "209-462-9900",
            "fax_number": "209-462-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAVDEEP DHALIWAL, M.D. A PROF.CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DHALIWAL",
        "authorized_official_first_name": "NAVDEEP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-462-9900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0015X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6430436",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.