Provider Demographics
NPI:1174655401
Name:GREWAL, INDERJIT SINGH
Entity Type:Individual
Prefix:DR
First Name:INDERJIT
Middle Name:SINGH
Last Name:GREWAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 686
Mailing Address - Street 2:
Mailing Address - City:SOLEDAD
Mailing Address - State:CA
Mailing Address - Zip Code:93960-0686
Mailing Address - Country:US
Mailing Address - Phone:831-678-5982
Mailing Address - Fax:831-678-5908
Practice Address - Street 1:C.T.F.
Practice Address - Street 2:5 MILES N OF SOLEDAD
Practice Address - City:SOLEDAD
Practice Address - State:CA
Practice Address - Zip Code:93960-0686
Practice Address - Country:US
Practice Address - Phone:831-678-5982
Practice Address - Fax:831-678-5908
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-36452207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine