Individual
DR. PARDEEP ATHWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
768 MOUNTAIN RANCH RD, SAN ANDREAS, CA 95249-9707
(209) 754-2573
Mailing address
450 GLASS LN STE C, MODESTO, CA 95356-9287
(209) 342-2300
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
144278
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2010
Last updated
11/06/2018
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