Healthcare Provider Details

I. General information

NPI: 1831913870
Provider Name (Legal Business Name): GRPC GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2024
Last Update Date: 05/10/2025
Certification Date: 05/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4527 W SAHARA AVE
LAS VEGAS NV
89102-3760
US

IV. Provider business mailing address

4527 W SAHARA AVE
LAS VEGAS NV
89102-3760
US

V. Phone/Fax

Practice location:
  • Phone: 702-490-1234
  • Fax: 702-912-4078
Mailing address:
  • Phone: 702-912-4077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JIMMY SINGH DHALIWAL
Title or Position: PRESIDENT
Credential:
Phone: 702-490-1234