Basic Information
Provider Information
NPI: 1386751188
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TALWAR
FirstName: INDU
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2311 LOVERIDGE RD
Address2: 2ND FLOOR
City: PITTSBURG
State: CA
PostalCode: 945655117
CountryCode: US
TelephoneNumber: 9254312600
FaxNumber: 9254312676
Practice Location
Address1: 2311 LOVERIDGE RD
Address2: 2ND FLOOR
City: PITTSBURG
State: CA
PostalCode: 945655117
CountryCode: US
TelephoneNumber: 9254312600
FaxNumber: 9254312676
Other Information
ProviderEnumerationDate: 08/25/2006
LastUpdateDate: 12/03/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X240774NYY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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