Provider Demographics
NPI:1427038074
Name:KAUR, HARRUP (MD, MHSC)
Entity Type:Individual
Prefix:
First Name:HARRUP
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:MD, MHSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 KNOWLES DR
Mailing Address - Street 2:SUITE 117
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1549
Mailing Address - Country:US
Mailing Address - Phone:408-940-3930
Mailing Address - Fax:408-940-3945
Practice Address - Street 1:555 KNOWLES DR
Practice Address - Street 2:SUITE 117
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1549
Practice Address - Country:US
Practice Address - Phone:408-940-3930
Practice Address - Fax:408-940-3945
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97285207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN422955000Medicaid
CA1427038074Medicaid
CACG574XMedicare PIN
CACG574ZMedicare PIN
H94552Medicare UPIN
MN180001134Medicare ID - Type Unspecified
MN422955000Medicaid
CA1427038074Medicaid
CACG574WMedicare PIN