Provider Demographics
NPI:1427038736
Name:JINDAL, PRATEEK (DO)
Entity Type:Individual
Prefix:
First Name:PRATEEK
Middle Name:
Last Name:JINDAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3660 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3922
Mailing Address - Country:US
Mailing Address - Phone:951-697-5445
Mailing Address - Fax:951-653-3975
Practice Address - Street 1:6250 CLAY ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92509-6005
Practice Address - Country:US
Practice Address - Phone:951-360-5225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8647207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1730180415OtherGROUP NPI
020A86471Medicare ID - Type Unspecified
CA1730180415OtherGROUP NPI