Provider Demographics
NPI:1356833628
Name:GREWAL, INDERPREET (PHARMD)
Entity Type:Individual
Prefix:
First Name:INDERPREET
Middle Name:
Last Name:GREWAL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3075 BRUSH CREEK DR # 47
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-6826
Mailing Address - Country:US
Mailing Address - Phone:209-585-9071
Mailing Address - Fax:
Practice Address - Street 1:3075 BRUSH CREEK DR # 47
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-6826
Practice Address - Country:US
Practice Address - Phone:209-585-9071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-03
Last Update Date:2018-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78465183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist