Provider Demographics
NPI:1629563556
Name:KHALSA, HARSIMRAN (DC)
Entity Type:Individual
Prefix:DR
First Name:HARSIMRAN
Middle Name:
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 1:870 W ONSTOTT FRONTAGE RD STE G
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3500
Mailing Address - Country:US
Mailing Address - Phone:530-674-2803
Mailing Address - Fax:530-674-2859
Practice Address - Street 1:870 W ONSTOTT FRONTAGE RD STE G
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3500
Practice Address - Country:US
Practice Address - Phone:530-674-2803
Practice Address - Fax:530-674-2859
Is Sole Proprietor?:No
Enumeration Date:2018-06-23
Last Update Date:2018-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor