Provider Demographics
NPI:1821143264
Name:KHEHRA, BALRAJ SINGH (PT)
Entity Type:Individual
Prefix:MR
First Name:BALRAJ
Middle Name:SINGH
Last Name:KHEHRA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 E FLORIDA AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-4754
Mailing Address - Country:US
Mailing Address - Phone:951-237-8304
Mailing Address - Fax:951-777-5399
Practice Address - Street 1:2390 E FLORIDA AVE
Practice Address - Street 2:STE 201
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-4754
Practice Address - Country:US
Practice Address - Phone:951-237-8304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CAPT29052174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist