Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125057256 | IL |
N | 111NI0900X | Internist | 125057256 | IL |
Y | 207RC0000X | Internist - Cardiovascular Disease | A151270 | CA |
NPI | 1003048745 |
---|---|
Provider Name | Dr. Puneet Dhillon Grewal |
First Address | Stockton, CA 95204-6118 |
Second Address | Manteca, CA 95336-5961 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2009 |
Last Update Date | 21/02/2019 |