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NPI Code Detail

MEDICARE: JATINDER SINGH PUREWAL M.D.

MEDICARE: JATINDER SINGH PUREWAL M.D.
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
1208100000XPhysical Medicine & Rehabilitation Physician36732AZ

General Provider Information

NPI Number : 1790803237
Entity Type Code : Individual
Provider Name (Legal Business Name) : JATINDER SINGH PUREWAL M.D.
Provider Business Mailing Address
First Line : 5441W PARK VIEW LN
Second Line :
City : GLENDALE
State : AZ
Zip : 85310-2944
Country : US
Telephone Number : 623-334-0376
Fax Number :
Provider Business Practice Location Address
First Line : 6677W THUNDERBIRD RD I164
Second Line :
City : GLENDALE
State : AZ
Zip : 85306-3762
Country : US
Telephone Number : 623-334-0376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 08/02/2015

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