PRABHJIT S. PUREWAL, MD, INC. (NPI# 1063620888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063620888 |
| Entity Type | Organization |
| Organization Name | PRABHJIT S. PUREWAL, MD, INC. |
| Practice Address |
4722 Quail Lakes Dr Ste A Stockton CA 95207-5244 |
| Mailing Address |
Po Box 7935 Stockton CA 95267-0935 |
| Practice Telephone | 2094772000 |
| Practice Fax Number | 2094770248 |
| Mailing Telephone | 2094772000 |
| Mailing Fax Number | 2094770248 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2008-07-23 |
| Authorized Official Name | DR. PRABHJIT S PUREWAL (PRESIDENT) |
| Authorized Official Telephone | 2094772000 |
| Authorized Official Credential | MD, FACO |
| 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 | DMERC NUMBER | 5343040003 | 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 |
| 1548239338 | Prabhjit S. Purewal, Md, Inc. | Specialist | 165 St. Dominic's Dr, Ste 120, 140, Manteca, CA 95337-7802 | 2006-03-15 |
| 1831206432 | Prabhjit S. Purewal, Md, Inc. | Non-Pharmacy Dispensing Site | 200 Cottage Ave, Ste 201, Manteca, CA 95336-4935 | 2006-08-23 |
| Street Address |
4722 QUAIL LAKES DR STE A |
| City | STOCKTON |
| State | CA |
| Zip Code | 95207-5244 |
| 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 |
| 1619183613 | San Joaquin Hematology Oncology A PC | Specialist | 4722 Quail Lakes Dr Ste A, Stockton, CA 95207-5244 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669004438 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 1002 Robinhood Drive, Stockton, CA 95207 | 2020-02-10 |
| 1811533110 | Tanya V Jones | Dental Hygienist | Community Medical Centers, 83 W. March Ln., Stockton, CA 95207 | 2019-11-21 |
| 1053966358 | Ingrid Marcela Saavedra | Behavioral Analyst | 1545 Saint Marks Plaza Ste 9, Stockton, CA 95207 | 2019-08-05 |
| 1497218861 | Turning Point Community Programs | Community/Behavioral Health | 1803 W March Ln Ste C-d, Stockton, CA 95207 | 2019-04-11 |
| 1427510627 | Stockton Sleep Center Inc | Physiological Laboratory | 1545 Saint Marks Plaza, Suite 2, Stockton, CA 95207 | 2019-04-05 |
| 1518436229 | Nicolas Anthony Overby | Occupational Therapist | Windsor Elmhaven Care Cente 6940 Pacific Ave, Stockton, CA 95207 | 2018-11-26 |
| 1912475724 | Ashley Johnson | Behavior Technician | 87 W. March Ln. Suite 6, Stockton, CA 95207 | 2018-11-09 |
| 1124596085 | Korie Cottrell | Behavior Technician | 87 W. March Ln., Suite 6, Stockton, CA 95207 | 2018-11-08 |
| 1760979645 | Maria Esther Rodriguez | Counselor | 2425 W March Ln., Stockton, CA 95207 | 2018-04-17 |
| 1902301161 | Lashray Elliott | Behavior Technician | 2291 W. Mach Lane, Ste C101, Stockton, CA 95207 | 2018-03-28 |
| Find all providers in zip 95207 | ||||
| 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 |
|---|---|---|---|---|
| 1063943223 | Medcore Hp | Specialist | 2701 E Hammer Ln, Suite 103, Stockton, CA 95210-4245 | 2017-03-21 |
| 1730577917 | Kathryn Debaca | Specialist | 1424 Morrison Ave, Stockton, CA 95205-3538 | 2014-12-22 |
| 1538575428 | Sarah R.a. Pavis | Specialist | 7489 Shoreline Dr, Stockton, CA 95219-4587 | 2014-07-11 |
| 1033451976 | Sheila E Buchbinder | Specialist | 205 Sandy Ridge Mount Airy Rd, Stockton, NJ 08559-1904 | 2013-03-18 |
| 1861751273 | Thomas Tao-yuan Chen | Specialist | 2220 Broadridge Way, Stockton, CA 95209-1247 | 2012-05-07 |
| 1801107438 | Treedeen Tether | Specialist | 3591 Quail Lakes Dr, Unit 136, Stockton, CA 95207-5234 | 2010-06-29 |
| 1578739173 | Sue Yi Shia | Specialist | 1422 William Moss Blvd, Stockton, CA 95206-5666 | 2008-05-02 |
| 1801095419 | Kristine Joanne Andres | Specialist | 1304 Sagewood Ct, Stockton, CA 95210-3527 | 2007-07-13 |
| 1689880064 | Prabhjit S. Purewal, Md, Inc. | Specialist | 4722 Quail Lakes Dr Ste A, Stockton, CA 95207-5244 | 2007-05-15 |
| 1720208481 | Ronald C. Allison M.d. Inc. | Specialist | 415 E Harding Way Ste H, Stockton, CA 95204-6118 | 2007-04-26 |
| Find all providers in STOCKTON | ||||
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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.