Provider Demographics
NPI:1255345112
Name:POONIA, ROOPINDER S (MD)
Entity type:Individual
Prefix:
First Name:ROOPINDER
Middle Name:S
Last Name:POONIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ROOPINDER
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6555 COYLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-0302
Mailing Address - Country:US
Mailing Address - Phone:916-733-3344
Mailing Address - Fax:916-733-5365
Practice Address - Street 1:6555 COYLE AVENUE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0302
Practice Address - Country:US
Practice Address - Phone:916-733-3344
Practice Address - Fax:916-733-5365
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96233207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1255345112Medicaid
CAP00803741OtherMEDICARE RAILROAD #
CACM304ZMedicare PIN