Provider Demographics
NPI:1689671034
Name:SEHGAL, KISHORE (MD)
Entity Type:Individual
Prefix:DR
First Name:KISHORE
Middle Name:
Last Name:SEHGAL
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 1:40229 DONOMORE CT
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-1611
Mailing Address - Country:US
Mailing Address - Phone:951-695-2648
Mailing Address - Fax:
Practice Address - Street 1:301 N SAN JACINTO ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3113
Practice Address - Country:US
Practice Address - Phone:951-766-6460
Practice Address - Fax:951-766-6459
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42484174400000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1962696344OtherMEDICARE PART B DME
CA5945420001OtherMEDICARE PART D DME
CA5945420004OtherMEDICARE PART D DME
CA05D1062719OtherCLIA NUMBER
CA1558555938OtherMEDICARE PART B DME
CA5945420002OtherMEDICARE PART D DME
CA5945420003OtherMEDICARE PART D DME
CA00A424840Medicaid
CA1225222029OtherMEDICARE PART B DME
CA1457545840OtherMEDICARE PART B DME
CA5945420002OtherMEDICARE PART D DME
CAE33311Medicare UPIN