Provider Demographics
NPI:1497852446
Name:KAHLON, VASDEEP SINGH (MD)
Entity Type:Individual
Prefix:
First Name:VASDEEP
Middle Name:SINGH
Last Name:KAHLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:VASDEV
Other - Middle Name:SINGH
Other - Last Name:KAHLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:662 MOWRY AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-4113
Mailing Address - Country:US
Mailing Address - Phone:510-792-6199
Mailing Address - Fax:510-792-0731
Practice Address - Street 1:662 MOWRY AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-4113
Practice Address - Country:US
Practice Address - Phone:510-792-6199
Practice Address - Fax:510-792-0731
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0512432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD80622Medicare UPIN
CA00A512430Medicare ID - Type Unspecified