Provider Demographics
NPI:1386073922
Name:RAWAL, SUMEET K (PA-C)
Entity type:Individual
Prefix:
First Name:SUMEET
Middle Name:K
Last Name:RAWAL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SUMIT
Other - Middle Name:K
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:393 E WALNUT ST
Mailing Address - Street 2:FL 3
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91188-0001
Mailing Address - Country:US
Mailing Address - Phone:800-851-0211
Mailing Address - Fax:
Practice Address - Street 1:9449 IMPERIAL HWY STE 130
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-2814
Practice Address - Country:US
Practice Address - Phone:562-657-2821
Practice Address - Fax:562-657-4675
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA23282363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA23282OtherCA LICENCE