PRABHJIT S. PUREWAL, MD, INC. (NPI# 1548239338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548239338 |
| Entity Type | Organization |
| Organization Name | PRABHJIT S. PUREWAL, MD, INC. |
| Practice Address |
165 St. Dominic's Dr Ste 120, 140 Manteca CA 95337-7802 |
| Mailing Address |
Po Box 7935 Stockton CA 95267-0935 |
| Practice Telephone | 2098230000 |
| Practice Fax Number | 2098241449 |
| Mailing Telephone | 2098230000 |
| Mailing Fax Number | 2098241449 |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2011-04-14 |
| Authorized Official Name | DR. PRABHJIT S PUREWAL (CEO) |
| Authorized Official Telephone | 2098230000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | A48423 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RAILROAD MEDICARE | P00023054 | 01 |
| CA | 00A484230 | 05 | |
| CA | BLUE SHIELD | ZZZ66761Z | 01 |
| CA | MEDI CAL | 00A484231 | 01 |
| CA | MEDICARE | ZZZ23785Z | 01 |
| CA | BLUE SHIELD | ZZZ65257Y | 01 |
| CA | MEDICARE ID -TYPE UNSPECIFIED | A484230 | 01 |
| CA | RAILRODA MEDICARE | DA3789 | 01 |
| CA | BLUE SHIELD | ZZZ06721Z | 01 |
| CA | BLUE SHIELD | ZZZ65255Y | 01 |
| CA | BLUE SHIELD | ZZZ65256Y | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689880064 | Prabhjit S. Purewal, Md, Inc. | Specialist | 4722 Quail Lakes Dr Ste A, Stockton, CA 95207-5244 | 2007-05-15 |
| 1063620888 | Prabhjit S. Purewal, Md, Inc. | Specialist | 4722 Quail Lakes Dr Ste A, Stockton, CA 95207-5244 | 2007-05-18 |
| 1831206432 | Prabhjit S. Purewal, Md, Inc. | Non-Pharmacy Dispensing Site | 200 Cottage Ave, Ste 201, Manteca, CA 95336-4935 | 2006-08-23 |
| Street Address |
165 ST. DOMINIC'S DR STE 120, 140 |
| City | MANTECA |
| State | CA |
| Zip Code | 95337-7802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902801012 | Prabhjit S Purewal | Specialist | 165 St. Dominic's Dr, Ste 120, 140, Manteca, CA 95337-7802 | 2005-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640485 | Shanitta D Hines | Counselor | Victor Community Support Services, 302 Cherry Lane, CA 95337 | 2020-08-19 |
| 1548658685 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 401 S Airport Way, Manteca, CA 95337 | 2014-12-23 |
| 1225430655 | Elizabeth Julia Ann Tyner | Hearing Instrument Specialist | 1079 Eucalyptus, Suite B, Manteca, CA 95337 | 2014-09-17 |
| 1134565740 | Aegis Treatment Centers, LLC | Clinic/Center | 955 W. Center Street, Suites 12a, 12b & 14, Manteca, CA 95337 | 2013-05-22 |
| 1053668947 | Roger Cabo Inciong | Physical Therapist | 3652 Rapallo Way, Manteca, CA 95337 | 2012-08-09 |
| 1295997757 | Costco Wholesale Corporation | Pharmacy | 2440 Daniels St, Manteca, CA 95337 | 2008-06-26 |
| 1255474235 | Carmen Catherine Nunes | Marriage & Family Therapist | 1771 Yosemite Ave., Manteca, CA 95337 | 2007-02-15 |
| 1063577062 | Kathy Laverne Barron | Counselor | 1789 W. Yosemite Ave., Sierra Building, 1st Floor, Manteca, CA 95337 | 2006-12-27 |
| 1891853149 | R. Ciccarelli, Dds., R. Joseph, Dds., M. El Farra, Dds., D. Saini, Dds | Dentist | 1507 W. Yosemite, Manteca, CA 95337 | 2006-12-05 |
| 1467528265 | Annie Mathew | Pharmacist | 1777 West Yosemite Ave, Manteca, CA 95337 | 2006-11-27 |
| Find all providers in zip 95337 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245783869 | Jonathan Yager | Specialist | 20801 S Woodward Ave Spc 35, Manteca, CA 95337-9264 | 2016-07-31 |
| 1972870988 | Jackie Friedrikson | Specialist | 207 W Center St, Manteca, CA 95336-4540 | 2011-11-18 |
| 1942510367 | Kathryn Lee Wright | Specialist | 1138 Collins St, Manteca, CA 95337-8641 | 2010-10-19 |
| 1457423279 | Catherine F Mathis | Specialist | 1234 E. North St, Suite 102, Manteca, CA 95336 | 2006-11-15 |
| 1508807066 | Tan D Tran | Specialist | 292 Cottage Ave, Manteca, CA 95336-4942 | 2006-06-08 |
| 1528035573 | Sanjeev Vaishampayan | Specialist | 1148 Norman Dr Ste 3, Manteca, CA 95336-5961 | 2006-03-08 |
| 1740648856 | Valley Cancer Medical Center Inc | Specialist | 1138 Norman Dr, Ste 101, Manteca, CA 95336-5965 | 2016-02-03 |
| 1922179290 | Steve J Tredway | Specialist | 1777 W Yosemite Ave, Manteca, CA 95337-5130 | 2006-11-10 |
| 1578653028 | Tonja Lynette Harris-stansil | Specialist | 1234 E North St, Ste. 102, Manteca, CA 95336-4960 | 2006-10-13 |
| 1013931781 | Center for Sight of Stockton A Medical Corporation | Specialist | 1144 Norman Dr, Suite 102, Manteca, CA 95336-5925 | 2006-07-27 |
| Find all providers in MANTECA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.