Provider Demographics
NPI:1851971428
Name:KHUNKHUN, PRABHDEEP (MD)
Entity Type:Individual
Prefix:
First Name:PRABHDEEP
Middle Name:
Last Name:KHUNKHUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 FIELDGATE CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-3001
Mailing Address - Country:US
Mailing Address - Phone:408-613-0568
Mailing Address - Fax:
Practice Address - Street 1:4228 HOUMA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-3004
Practice Address - Country:US
Practice Address - Phone:504-454-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program