Provider Demographics
NPI:1427190487
Name:GAREWAL, JAGDEEP SINGH (MD)
Entity Type:Individual
Prefix:
First Name:JAGDEEP
Middle Name:SINGH
Last Name:GAREWAL
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:PO BOX 21314
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-1314
Mailing Address - Country:US
Mailing Address - Phone:661-332-0775
Mailing Address - Fax:888-263-8551
Practice Address - Street 1:1707 EYE ST # 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5208
Practice Address - Country:US
Practice Address - Phone:661-310-3688
Practice Address - Fax:661-368-0826
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA640952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1427190487Medicaid
CA1427190487Medicaid
KSG65822Medicare UPIN
CACE083WMedicare PIN
CA00A640952Medicare PIN
00A640952Medicare PIN