Prabhjit S. Purewal, MD, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A48423 Issued in CA

Legal business name

PRABHJIT S. PUREWAL, MD, INC.

Practice address

165 St. Dominic's Dr
Ste 120, 140
Manteca, CA 95337-7802

Phone

(209) 823-0000

Fax

(209) 824-1449

NPI assigned

Mar 15, 2006

Last updated

Apr 14, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Prabhjit S Purewal, MD

Title

Ceo

Phone

(209) 823-0000

Specialties & licenses 1

Addresses

Other identifiers 11

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302739200000",
    "number": "1548239338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7935",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670935",
            "telephone_number": "209-823-0000",
            "fax_number": "209-824-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 ST. DOMINIC'S DR",
            "address_2": "STE 120, 140",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953377802",
            "telephone_number": "209-823-0000",
            "fax_number": "209-824-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRABHJIT S. PUREWAL, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2011-04-14",
        "status": "A",
        "authorized_official_last_name": "PUREWAL",
        "authorized_official_first_name": "PRABHJIT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-823-0000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A48423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00023054",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ06721Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ65256Y",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A484230",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID -TYPE UNSPECIFIED",
            "identifier": "A484230",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "ZZZ23785Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "00A484231",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ65255Y",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILRODA MEDICARE",
            "identifier": "DA3789",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ65257Y",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ66761Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Plascencia
• Delosmilagros Plaza de Loza, LVN
• Deborah Podbreger
• Nancy Beatriz Ponce Escobar, BA
• Prabhjit S. Purewal, MD, Inc
• Prabhjit S. Purewal, MD, Inc.
• Araceli Hernandez Prado
• Elizabeth Preciado
• Clinton Earl Prescott Jr., M.D.
• Dajea Price

• Specialist in Manteca, CA
• Providers in Manteca, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.