PRABHJIT S. PUREWAL, MD, INC. (NPI# 1831206432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831206432 |
| Entity Type | Organization |
| Organization Name | PRABHJIT S. PUREWAL, MD, INC. |
| Practice Address |
200 Cottage Ave Ste 201 Manteca CA 95336-4935 |
| Mailing Address |
Po Box 7935 Stockton CA 95267-0935 |
| Practice Telephone | 2094772000 |
| Practice Fax Number | 2094770248 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2009-06-22 |
| Authorized Official Name | PRABHJIT PUREWAL (CEO) |
| Authorized Official Telephone | 2094772000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | A48423 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A48423 | 05 | |
| OTHER ID NUMBER | 5622368 | 01 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 5622368 | 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 |
| 1063620888 | Prabhjit S. Purewal, Md, Inc. | Specialist | 4722 Quail Lakes Dr Ste A, Stockton, CA 95207-5244 | 2007-05-18 |
| Street Address |
200 COTTAGE AVE STE 201 |
| City | MANTECA |
| State | CA |
| Zip Code | 95336-4935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031693 | Michael Steven Davis | Internal Medicine | 200 Cottage Ave, Ste 203, Manteca, CA 95336-4935 | 2005-05-31 |
| 1548494974 | Greater Modesto Medical Surgical Associates, Inc. | Urology | 200 Cottage Ave, Suite 101, Manteca, CA 95336-4935 | 2009-05-13 |
| 1912183153 | Mchenry Medical Group, Inc. | Urology | 200 Cottage Ave, Sute 101, Manteca, CA 95336-4935 | 2008-01-17 |
| 1841471166 | Russell P Carter Jr Md Inc | Internal Medicine | 200 Cottage Ave, Suite 201, Manteca, CA 95336-4935 | 2007-11-15 |
| 1477675387 | Central Valley Eye Medical Group Inc. | Eyewear Supplier (Equipment, not the service) | 200 Cottage Ave, Ste 102, Manteca, CA 95336-4935 | 2007-04-04 |
| 1700942190 | Sleepmed of California | Durable Medical Equipment & Medical Supplies | 200 Cottage Ave, Ste 201, Manteca, CA 95336-4935 | 2006-12-29 |
| 1760594089 | Carmelita Casison Nisperos | Pediatrics | 200 Cottage Ave, Suite 202, Manteca, CA 95336-4935 | 2006-08-31 |
| 1760494066 | Holly Noel Reece | Physician Assistant | 200 Cottage Ave, Ste 103, Manteca, CA 95336-4935 | 2006-08-13 |
| 1225073588 | Valley Associated Urology Medicare Group Inc | Urology | 200 Cottage Ave, Ste 101, Manteca, CA 95336-4935 | 2006-06-19 |
| 1649222118 | Prabhjit S. Purewal, Md, Inc | Specialist | 200 Cottage Ave, Ste 201, Manteca, CA 95336-4935 | 2006-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225687676 | Kasside Sahagun-escalante | Behavior Technician | 402 Victory Ave, Manteca, CA 95336 | 2019-09-09 |
| 1295253797 | Adriana Pena | Counselor | 129 E.center Street Ste.3, Manteca, CA 95336 | 2017-09-05 |
| 1104352277 | Native Directions Inc. | Substance Abuse Rehabilitation Facility | 13505 Union Rd, Manteca, CA 95336 | 2017-05-10 |
| 1437508389 | Anna Gavin | Contractor | 1256 W. Lathrop Rd #376, Manteca, CA 95336 | 2016-06-10 |
| 1164826137 | Michael M. Catz, M.d., Inc | Anesthesiology | 1205 E. North Street, Manteca, CA 95336 | 2014-10-20 |
| 1033518923 | Leanne Louis | Community Health Worker | 129 E Center Street, #3, Manteca, CA 95336 | 2014-08-18 |
| 1255684122 | Kenneth S. Ching, Md., Inc | Anesthesiology | 1205 East North Street, Manteca, CA 95336 | 2012-10-17 |
| 1629323043 | Harpradeep Ratia | Dentist | 1332 E Yosemite Ave, Manteca, CA 95336 | 2012-07-23 |
| 1750643664 | Shelley Marie Kohl | Specialist/Technologist, Other | 425 E. Center St Suite 1, Manteca, CA 95336 | 2012-06-15 |
| 1932488038 | Valerie Diane Segura | Behavioral Analyst | 1882 Cherrywood Pl, Manteca, CA 95336 | 2011-08-08 |
| Find all providers in zip 95336 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801417316 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 296 Cottage Ave, Manteca, CA 95336-4942 | 2020-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982225496 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 5757 Pacific Ave Ste 228, Stockton, CA 95207-5159 | 2020-05-06 |
| 1285268391 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 1337 S Lovers Ln Ste D, Visalia, CA 93292-5249 | 2020-02-27 |
| 1790327732 | Triumph Specialties LLC | Non-Pharmacy Dispensing Site | 11100 Sepulveda Blvd # 8-519, Mission Hills, CA 91345-1131 | 2019-10-10 |
| 1487210365 | Artius Dermatology Associates P.C. | Non-Pharmacy Dispensing Site | 325 Mall Dr Ste 111, Hanford, CA 93230-5950 | 2019-05-15 |
| 1376030080 | Jane F Kardashian Md Inc | Non-Pharmacy Dispensing Site | 6769 N Fresno, Fresno, CA 93710 | 2018-04-18 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1043719206 | Southern California Orthopedic Institute L.p | Non-Pharmacy Dispensing Site | 4100 Empire Dr Ste 120, Bakersfield, CA 93309-0408 | 2018-02-02 |
| 1174032353 | Golden Gate Urology, Inc. | Non-Pharmacy Dispensing Site | 139 Townsend St Ste 100, San Francisco, CA 94107-1946 | 2017-09-20 |
| 1215462080 | Mas Management Group, Inc. | Non-Pharmacy Dispensing Site | 28446 Constellation Rd, Valencia, CA 91355-5081 | 2017-04-28 |
| 1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
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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.