Provider Demographics
NPI:1538556592
Name:GREWAL, DENNIS (DO)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:GREWAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:BACHITER
Other - Middle Name:
Other - Last Name:GREWAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:700 N TUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3602
Mailing Address - Country:US
Mailing Address - Phone:714-245-1444
Mailing Address - Fax:714-953-6604
Practice Address - Street 1:700 N TUSTIN AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3602
Practice Address - Country:US
Practice Address - Phone:714-245-1444
Practice Address - Fax:714-245-1444
Is Sole Proprietor?:No
Enumeration Date:2015-04-16
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15476207RC0000X
CA20A15476207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine