Provider Demographics
NPI:1922863471
Name:SATINDER S. PUREWAL, M.D. LLC
Entity Type:Organization
Organization Name:SATINDER S. PUREWAL, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-878-2100
Mailing Address - Street 1:6677 W THUNDERBIRD RD STE I164
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-3762
Mailing Address - Country:US
Mailing Address - Phone:238-782-1006
Mailing Address - Fax:
Practice Address - Street 1:42104 N VENTURE DR STE D106
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-3836
Practice Address - Country:US
Practice Address - Phone:623-878-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty