Provider Demographics
NPI:1528104197
Name:GREWAL, KULDIP SINGH (DC)
Entity type:Individual
Prefix:DR
First Name:KULDIP
Middle Name:SINGH
Last Name:GREWAL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1753 LANDESS AVENUE
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-7019
Mailing Address - Country:US
Mailing Address - Phone:408-942-8787
Mailing Address - Fax:408-942-9184
Practice Address - Street 1:1753 LANDESS AVENUE
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-7019
Practice Address - Country:US
Practice Address - Phone:408-942-8787
Practice Address - Fax:408-942-9184
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15561111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor