Organization Active NPI

Ajita Grewal MD Inc

  • Ophthalmology Physician
  • Los Altos, CA
National Provider Identifier
1659514123
Registry record updated Oct 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A61389 Issued in CA
Legal business name
AJITA GREWAL MD INC
Practice address
762 Altos Oaks Dr
Suite 1
Los Altos, CA 94024-5434
Phone
(650) 948-9123
Fax
(650) 948-0563
NPI assigned
Apr 14, 2009
Last updated
Oct 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2009

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

Authorized official

Name
Ajita Grewal, M.D.NPI 1669491486
Title
President
Phone
(650) 948-9123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A61389 CA Primary

Addresses

Primary practice location

762 Altos Oaks Dr
Suite 1
Los Altos, CA 94024-5434

Mailing address

762 Altos Oaks Dr
Suite 1
Los Altos, CA 94024-5434
Phone (650) 948-9123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090725000051 CA Part B Supplier - Clinic/Group Practice 3678626538 Receives reassigned benefits from 1 practitioner
Practice locations: Los Altos, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254700800000",
    "number": "1659514123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 ALTOS OAKS DR",
            "address_2": "SUITE 1",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245434",
            "telephone_number": "650-948-9123",
            "fax_number": "650-948-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 ALTOS OAKS DR",
            "address_2": "SUITE 1",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940245434",
            "telephone_number": "650-948-9123",
            "fax_number": "650-948-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AJITA GREWAL MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-14",
        "last_updated": "2009-10-05",
        "status": "A",
        "authorized_official_last_name": "GREWAL",
        "authorized_official_first_name": "AJITA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-948-9123",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A61389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Altos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.