Provider Demographics
NPI:1679078885
Name:GREWAL, RAVLEEN KAUR (MD)
Entity type:Individual
Prefix:
First Name:RAVLEEN
Middle Name:KAUR
Last Name:GREWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2626 N CALIFORNIA ST STE B
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-5500
Mailing Address - Country:US
Mailing Address - Phone:209-466-2626
Mailing Address - Fax:209-466-7153
Practice Address - Street 1:2626 N CALIFORNIA ST STE B
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5500
Practice Address - Country:US
Practice Address - Phone:209-466-2626
Practice Address - Fax:209-466-7153
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2025-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA195347207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology