Provider Demographics
NPI:1114614609
Name:KHINDA, JASKARAN
Entity Type:Individual
Prefix:
First Name:JASKARAN
Middle Name:
Last Name:KHINDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25647
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91185-5647
Mailing Address - Country:US
Mailing Address - Phone:888-851-3677
Mailing Address - Fax:888-851-3671
Practice Address - Street 1:3478 BUSKIRK AVE #218
Practice Address - Street 2:
Practice Address - City:CA
Practice Address - State:CA
Practice Address - Zip Code:94523-4383
Practice Address - Country:US
Practice Address - Phone:888-851-3677
Practice Address - Fax:888-851-3671
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4921246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic