Provider Demographics
NPI:1558759258
Name:KHALSA, HARI SIMRAN SINGH (DC)
Entity Type:Individual
Prefix:DR
First Name:HARI SIMRAN
Middle Name:SINGH
Last Name:KHALSA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:ANAHOLA
Mailing Address - State:HI
Mailing Address - Zip Code:96703-0640
Mailing Address - Country:US
Mailing Address - Phone:510-507-0264
Mailing Address - Fax:
Practice Address - Street 1:4800 KAWAIHAU RD
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-1971
Practice Address - Country:US
Practice Address - Phone:510-507-0264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-03
Last Update Date:2015-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1227111N00000X
CA27992111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor