Healthcare Provider Details

I. General information

NPI: 1568510220
Provider Name (Legal Business Name): PERMINDER S. PARMAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10666 N TORREY PINES RD MS 212
LA JOLLA CA
92037-1027
US

IV. Provider business mailing address

10666 N TORREY PINES RD MS 212
LA JOLLA CA
92037-1027
US

V. Phone/Fax

Practice location:
  • Phone: 858-554-8964
  • Fax: 858-554-6971
Mailing address:
  • Phone: 858-554-8964
  • Fax: 858-554-6971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA115359
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number234896
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: