Provider Demographics
NPI:1831290477
Name:GREWAL, SHARNJIT SINGH (MD)
Entity Type:Individual
Prefix:
First Name:SHARNJIT
Middle Name:SINGH
Last Name:GREWAL
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 1:10470 OLD PLACERVILLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:1160 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-3710
Practice Address - Country:US
Practice Address - Phone:916-865-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88367207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A883670Medicaid
CA2688874OtherPACIFICARE
CA7094828OtherAETNA
CA5702690OtherFIRST HEALTH
CA2688874OtherUNITED HEALTHCARE
CAA88367OtherBLUE CROSS
CA1795133OtherCIGNA
CA455481OtherINTERPLAN
CA131492OtherHEALTH NET
CA1887614OtherGREAT WEST
CAMCMG470400OtherWESTERN HEALTH ADVANTAGE
CA000810796017OtherPHCS
CA00A883670OtherBLUE SHIELD
CA7094828OtherAETNA
CA455481OtherINTERPLAN