Provider Demographics
NPI:1184814758
Name:RANDHAWA, KIRANJOT KAUR (DO)
Entity Type:Individual
Prefix:DR
First Name:KIRANJOT
Middle Name:KAUR
Last Name:RANDHAWA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-5622
Mailing Address - Country:US
Mailing Address - Phone:562-933-0494
Mailing Address - Fax:
Practice Address - Street 1:455 E COLUMBIA ST
Practice Address - Street 2:SUITE 201 & 6
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1620
Practice Address - Country:US
Practice Address - Phone:562-933-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2OA9915207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine