Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PRABHJIT S. PUREWAL, MD, INC.
Active
Organization
PRABHJIT S. PUREWAL, MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRABHJIT S PUREWAL MD (CEO)
(209) 823-0000
Entity
Organization
Contact information
Practice address
165 ST. DOMINIC'S DR, STE 120, 140, MANTECA, CA 95337-7802
(209) 823-0000
(209) 824-1449
Mailing address
PO BOX 7935, STOCKTON, CA 95267-0935
(209) 823-0000
(209) 824-1449
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A48423
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A484230
—
CA
01
—
00A484231
MEDI CAL
CA
01
—
A484230
MEDICARE ID -TYPE UNSPECIFIED
CA
01
—
DA3789
RAILRODA MEDICARE
CA
01
—
P00023054
RAILROAD MEDICARE
CA
01
—
ZZZ06721Z
BLUE SHIELD
CA
01
—
ZZZ23785Z
MEDICARE
CA
01
—
ZZZ65255Y
BLUE SHIELD
CA
01
—
ZZZ65256Y
BLUE SHIELD
CA
01
—
ZZZ65257Y
BLUE SHIELD
CA
01
—
ZZZ66761Z
BLUE SHIELD
CA
Enumeration date
03/15/2006
Last updated
04/14/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up