Provider Demographics
NPI:1588472450
Name:DHALIWAL, TANVEER (FNP-C)
Entity type:Individual
Prefix:
First Name:TANVEER
Middle Name:
Last Name:DHALIWAL
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5204 SKYLER CT
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-3880
Mailing Address - Country:US
Mailing Address - Phone:661-549-0444
Mailing Address - Fax:
Practice Address - Street 1:5204 SKYLER CT
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521-3880
Practice Address - Country:US
Practice Address - Phone:661-549-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95033363363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily