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Organization
SHIVINDER S DEOL M D INC
Active
Organization
SHIVINDER S DEOL M D INC
Active
Other names
Anti-Aging & Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIVINDER S DEOL M.D. (PRESIDENT)
(661) 325-7452
Entity
Organization
Contact information
Practice address
4000 STOCKDALE HWY, STE D, BAKERSFIELD, CA 93309-2059
(661) 325-7452
(661) 325-7456
Mailing address
4000 STOCKDALE HWY STE D, BAKERSFIELD, CA 93309-2059
(661) 325-7452
(661) 325-7456
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A37723
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080004729
PTAN
—
05
—
84411017
—
CA
Enumeration date
10/22/2010
Last updated
08/18/2026
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