Provider Demographics
NPI:1750971271
Name:PUNIA, RAMANPAL KAUR
Entity type:Individual
Prefix:
First Name:RAMANPAL
Middle Name:KAUR
Last Name:PUNIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RAMANPAL
Other - Middle Name:KAUR
Other - Last Name:GREWAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1700 N WATERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-5115
Mailing Address - Country:US
Mailing Address - Phone:909-883-8611
Mailing Address - Fax:909-881-5707
Practice Address - Street 1:1700 N WATERMAN AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-5115
Practice Address - Country:US
Practice Address - Phone:909-883-8611
Practice Address - Fax:909-881-5707
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95016301363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner