Healthcare Provider Details

I. General information

NPI: 1356975676
Provider Name (Legal Business Name): BALVEEN KAUR PUREWAL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 S RAYMOND AVE
ALHAMBRA CA
91801-7100
US

IV. Provider business mailing address

22022 100TH CT SE
KENT WA
98031-2537
US

V. Phone/Fax

Practice location:
  • Phone: 626-570-8005
  • Fax: 626-570-5639
Mailing address:
  • Phone: 206-816-4567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95332062
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN6049588
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61082245
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95026668
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: