Provider Demographics
NPI:1487633764
Name:KHAIRA, AJIT SINGH (MD)
Entity Type:Individual
Prefix:MR
First Name:AJIT
Middle Name:SINGH
Last Name:KHAIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3120 TULARE ST
Mailing Address - Street 2:#102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1443
Mailing Address - Country:US
Mailing Address - Phone:559-233-0933
Mailing Address - Fax:559-233-4364
Practice Address - Street 1:3120 TULARE ST
Practice Address - Street 2:#102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1443
Practice Address - Country:US
Practice Address - Phone:559-233-0933
Practice Address - Fax:559-233-4364
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2008-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA46411207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A464112Medicaid
E33243Medicare UPIN
CA00A464112Medicare Oscar/Certification