Provider Demographics
NPI:1649364720
Name:SAWHNEY, PARMELA (MD)
Entity type:Individual
Prefix:
First Name:PARMELA
Middle Name:
Last Name:SAWHNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 1ST ST
Mailing Address - Street 2:STE 6
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-1491
Mailing Address - Country:US
Mailing Address - Phone:619-424-5106
Mailing Address - Fax:619-424-3648
Practice Address - Street 1:705 PALM AVE
Practice Address - Street 2:
Practice Address - City:IMPERIAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:91932-1229
Practice Address - Country:US
Practice Address - Phone:619-424-5106
Practice Address - Fax:619-424-3648
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37796207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G377960Medicaid
CAG37796Medicare ID - Type Unspecified
CA00G377960Medicaid