Provider Demographics
NPI:1417910407
Name:MARWAHA, JATINDER PAL SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:JATINDER
Middle Name:PAL SINGH
Last Name:MARWAHA
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 1:1081 MARKET PL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4773
Mailing Address - Country:US
Mailing Address - Phone:925-866-8800
Mailing Address - Fax:925-866-8802
Practice Address - Street 1:1081 MARKET PL
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4773
Practice Address - Country:US
Practice Address - Phone:925-866-8800
Practice Address - Fax:925-866-8802
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56143207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A561430Medicare ID - Type Unspecified
G93933Medicare UPIN