Active NPI
Gursimran Singh Walia
- Pharmacist
- Tracy, CA
National Provider Identifier
1902562291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 85536
- Practice address
- 1801 W 11TH St
Tracy, CA 95376-3727 - Phone
- (209) 830-2950
- NPI assigned
- Nov 11, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 85536 | CA | Primary |
Addresses
Primary practice location
1801 W 11TH St
Tracy, CA 95376-3727
Mailing address
33209 Great Salt Lake Dr
Fremont, CA 94555-1209
Phone (510) 648-5936
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85536 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636588800000",
"number": "1902562291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33209 GREAT SALT LAKE DR",
"city": "FREMONT",
"state": "CA",
"postal_code": "945551209",
"telephone_number": "510-648-5936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 W 11TH ST",
"city": "TRACY",
"state": "CA",
"postal_code": "953763727",
"telephone_number": "209-830-2950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALIA",
"first_name": "GURSIMRAN",
"middle_name": "SINGH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-11",
"last_updated": "2021-11-11",
"certification_date": "2021-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "85536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tracy, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.