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NPI Code Detail

MEDICARE: MANREET KAUR GREWAL

MEDICARE: MANREET KAUR GREWAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1639801079
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANREET KAUR GREWAL
Provider Business Mailing Address
First Line : 12500 BRUCEVILLE RD
Second Line :
City : ELK GROVE
State : CA
Zip : 95757-9784
Country : US
Telephone Number : 916-874-1987
Fax Number :
Provider Business Practice Location Address
First Line : 12500 BRUCEVILLE RD
Second Line :
City : ELK GROVE
State : CA
Zip : 95757-9784
Country : US
Telephone Number : 916-874-1987
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2022
Last Update Date : 06/02/2026

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Directions to “ MANREET KAUR GREWAL ” Practice Location

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