Provider Demographics
NPI:1144690660
Name:HUNDAL, DILRAJ (PHARM D)
Entity type:Individual
Prefix:
First Name:DILRAJ
Middle Name:
Last Name:HUNDAL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:DILRAJ
Other - Middle Name:
Other - Last Name:SIDHU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:PO BOX 772
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:91933-0772
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9831 CAMPO RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-1418
Practice Address - Country:US
Practice Address - Phone:619-461-9170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-26
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist