Provider Demographics
NPI:1275151482
Name:GAGANPREET K KHELA OD, P.C.
Entity Type:Organization
Organization Name:GAGANPREET K KHELA OD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAGANPREET
Authorized Official - Middle Name:K
Authorized Official - Last Name:KHELA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:559-243-6623
Mailing Address - Street 1:92 CITY LIMITS CIR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1059
Mailing Address - Country:US
Mailing Address - Phone:559-243-6623
Mailing Address - Fax:
Practice Address - Street 1:1614 MT DIABLO BLVD
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4518
Practice Address - Country:US
Practice Address - Phone:559-243-6623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty