Healthcare Provider Details

I. General information

NPI: 1235151218
Provider Name (Legal Business Name): MINNIE SARWAL M.D., PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 01/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 WELCH RD
PALO ALTO CA
94304-1601
US

IV. Provider business mailing address

305 WILLOWBROOK DR
PORTOLA VALLEY CA
94028-7841
US

V. Phone/Fax

Practice location:
  • Phone: 650-851-5268
  • Fax:
Mailing address:
  • Phone: 650-353-1532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberA70504
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: