Provider Demographics
NPI:1508902297
Name:PUROHIT, GIRDHARI SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:GIRDHARI
Middle Name:SINGH
Last Name:PUROHIT
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 1:1225 E LATHAM AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4423
Mailing Address - Country:US
Mailing Address - Phone:951-929-2800
Mailing Address - Fax:951-929-2303
Practice Address - Street 1:1225 E LATHAM AVE
Practice Address - Street 2:SUITE B
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4423
Practice Address - Country:US
Practice Address - Phone:951-929-2800
Practice Address - Fax:951-929-2303
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36387174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A363870Medicare ID - Type Unspecified