Provider Demographics
NPI:1962855155
Name:YUVRAJ GREWAL MD INC, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:YUVRAJ GREWAL MD INC, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YUVRAJ
Authorized Official - Middle Name:S
Authorized Official - Last Name:GREWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-288-5700
Mailing Address - Street 1:23861 MCBEAN PKWY STE A4
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2003
Mailing Address - Country:US
Mailing Address - Phone:661-888-1099
Mailing Address - Fax:661-888-1270
Practice Address - Street 1:23861 MCBEAN PKWY STE A4
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2003
Practice Address - Country:US
Practice Address - Phone:661-888-1099
Practice Address - Fax:661-888-1270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA143512174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty