Provider Demographics
NPI:1548465156
Name:AHLUWALIA, AJIT SINGH (MD, MHA)
Entity type:Individual
Prefix:
First Name:AJIT
Middle Name:SINGH
Last Name:AHLUWALIA
Suffix:
Gender:M
Credentials:MD, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26800 CROWN VALLEY PKWY STE 315
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-8039
Mailing Address - Country:US
Mailing Address - Phone:949-364-6000
Mailing Address - Fax:949-364-1204
Practice Address - Street 1:26800 CROWN VALLEY PKWY STE 315
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-8039
Practice Address - Country:US
Practice Address - Phone:949-364-6000
Practice Address - Fax:949-364-1204
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC55707207R00000X, 207RH0002X, 208M00000X
PAMD434121207RC0200X
VA0101241733207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI48423020OtherLICENSE
PA102155543Medicaid
PA125744Medicare PIN
WI48423020OtherLICENSE