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Organization
OPERATION BLUE STAR
Active
Organization
OPERATION BLUE STAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARDEEP SINGH AHULWALIA MD (OWNER)
(650) 450-0776
Entity
Organization
Contact information
Practice address
658 FREMONT AVE, LOS ALTOS, CA 94023-0659
(650) 268-8360
(650) 209-5911
Mailing address
PO BOX 659, LOS ALTOS, CA 94023-0659
(650) 268-8360
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A86707
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780885574
NPI
CA
Enumeration date
09/14/2011
Last updated
04/04/2014
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