Provider Demographics
NPI:1215905633
Name:BISLA, TAJINDER SINGH (MD)
Entity type:Individual
Prefix:
First Name:TAJINDER
Middle Name:SINGH
Last Name:BISLA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 22ND ST UNIT 120
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-7162
Mailing Address - Country:US
Mailing Address - Phone:916-792-2135
Mailing Address - Fax:209-577-6517
Practice Address - Street 1:1000 N OAK AVE
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449
Practice Address - Country:US
Practice Address - Phone:715-387-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62287207ZP0102X
WI84245207ZP0102X
WAMD00040009207ZP0102X
CAA062287207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8433278Medicaid
CAA062287Medicaid
WA203960OtherLABOR & INDUSTRIES
WA203960OtherLABOR & INDUSTRIES
WA8433278Medicaid