Provider Demographics
NPI:1306003504
Name:KHUNKHUN, VININDER SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:VININDER
Middle Name:SINGH
Last Name:KHUNKHUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1440 CANAL ST # TB33
Mailing Address - Street 2:DEPT. OF PSYCHIATRY
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2703
Mailing Address - Country:US
Mailing Address - Phone:504-988-5246
Mailing Address - Fax:504-988-7092
Practice Address - Street 1:1440 CANAL ST # TB33
Practice Address - Street 2:DEPT. OF PSYCHIATRY
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2703
Practice Address - Country:US
Practice Address - Phone:504-988-5246
Practice Address - Fax:504-988-7092
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4488412084P0804X
LAMD.2056962084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1080934Medicaid
PA295233OtherMEDICARE