Basic Information
| Provider Information | |||||||||
| NPI: | 1548465156 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AHLUWALIA | ||||||||
| FirstName: | AJIT | ||||||||
| MiddleName: | SINGH | ||||||||
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| Credential: | MD, MHA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26800 CROWN VALLEY PKWY STE 315 | ||||||||
| Address2: | |||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926918039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493646000 | ||||||||
| FaxNumber: | 9493641204 | ||||||||
| Practice Location | |||||||||
| Address1: | 26800 CROWN VALLEY PKWY STE 315 | ||||||||
| Address2: | |||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926918039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493646000 | ||||||||
| FaxNumber: | 9493641204 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2007 | ||||||||
| LastUpdateDate: | 10/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | C55707 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | MD434121 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RH0002X | C55707 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | 207RH0002X | 0101241733 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | 208M00000X | C55707 | CA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 48423020 | 01 | WI | LICENSE | OTHER | 102155543 | 05 | PA | MEDICAID |