Provider Demographics
NPI:1023372059
Name:KHANGURA, NINA KAUR (MD)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:KAUR
Last Name:KHANGURA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:916-733-3304
Mailing Address - Fax:916-733-5383
Practice Address - Street 1:8220 WYMARK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-6297
Practice Address - Country:US
Practice Address - Phone:916-691-8500
Practice Address - Fax:916-691-8599
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA138779207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine