Provider Demographics
NPI:1164539433
Name:JINDAL, HIRA LAL (MD)
Entity Type:Individual
Prefix:
First Name:HIRA
Middle Name:LAL
Last Name:JINDAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W COLLEGE ST
Mailing Address - Street 2:590
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-1163
Mailing Address - Country:US
Mailing Address - Phone:213-680-9190
Mailing Address - Fax:213-680-0246
Practice Address - Street 1:711 W COLLEGE ST
Practice Address - Street 2:590
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-1163
Practice Address - Country:US
Practice Address - Phone:213-680-9190
Practice Address - Fax:213-680-0246
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26281207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A262810Medicaid
CA00A262810Medicaid
CAA26281Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO.