Provider Demographics
NPI:1043310436
Name:PUREWAL, SARABJIT S (MD)
Entity Type:Individual
Prefix:
First Name:SARABJIT
Middle Name:S
Last Name:PUREWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3838 SAN DIMAS ST
Practice Address - Street 2:SUITE A-100
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2284
Practice Address - Country:US
Practice Address - Phone:661-327-8538
Practice Address - Fax:661-327-5432
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39435208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
330004701OtherRAILROAD MEDICARE
330004701OtherRAILROAD MEDICARE
A28886Medicare UPIN