Provider Demographics
NPI:1821514811
Name:GREWAL, SIMRAN (NP)
Entity Type:Individual
Prefix:
First Name:SIMRAN
Middle Name:
Last Name:GREWAL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SIMRANJEET
Other - Middle Name:KAUR
Other - Last Name:CHOHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 PARNASSUS AVE
Mailing Address - Street 2:# M314
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2203
Mailing Address - Country:US
Mailing Address - Phone:661-916-4140
Mailing Address - Fax:
Practice Address - Street 1:127 S SAN VICENTE BLVD STE A6100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3311
Practice Address - Country:US
Practice Address - Phone:310-423-2077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007156363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care