Provider Demographics
NPI:1598795668
Name:LUTHRA, INDERMOHAN SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:INDERMOHAN
Middle Name:SINGH
Last Name:LUTHRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35400 BOB HOPE DR STE 113
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1772
Mailing Address - Country:US
Mailing Address - Phone:760-328-7500
Mailing Address - Fax:760-328-0044
Practice Address - Street 1:35400 BOB HOPE DR STE 113
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-1772
Practice Address - Country:US
Practice Address - Phone:760-328-7500
Practice Address - Fax:760-328-0044
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA505642084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00-A505640Medicaid
CA00-A505640Medicaid
CAF97193Medicare UPIN