Provider Demographics
NPI:1720697709
Name:AMEET K. GREWAL MD, INC
Entity Type:Organization
Organization Name:AMEET K. GREWAL MD, INC
Other - Org Name:MONTEREY EAR, NOSE & THROAT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:AMEET
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:GREWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-896-9539
Mailing Address - Street 1:26 MONTSALAS DR
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5285
Mailing Address - Country:US
Mailing Address - Phone:510-896-9539
Mailing Address - Fax:
Practice Address - Street 1:880 CASS ST STE 209
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2909
Practice Address - Country:US
Practice Address - Phone:831-204-0282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1003130634OtherPERSONAL NPI NUMBER
CAGR0066350Medicaid