Provider Demographics
NPI:1871871681
Name:BAJWA, TANVEER SINGH (MD)
Entity type:Individual
Prefix:
First Name:TANVEER
Middle Name:SINGH
Last Name:BAJWA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5345 N EL DORADO ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5872
Mailing Address - Country:US
Mailing Address - Phone:209-993-7471
Mailing Address - Fax:209-478-4084
Practice Address - Street 1:5345 N EL DORADO ST
Practice Address - Street 2:SUITE 3
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5872
Practice Address - Country:US
Practice Address - Phone:209-993-7471
Practice Address - Fax:209-478-4084
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA129058207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine