Provider Demographics
NPI:1891916771
Name:CHAHAL, UMINDER KAUR (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:UMINDER
Middle Name:KAUR
Last Name:CHAHAL
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:MS
Other - First Name:UMI
Other - Middle Name:K
Other - Last Name:CHAHAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD, LD
Mailing Address - Street 1:3033 NW 63RD ST STE 250
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-3633
Mailing Address - Country:US
Mailing Address - Phone:405-879-3470
Mailing Address - Fax:
Practice Address - Street 1:15208 BURNING SPRING RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1321
Practice Address - Country:US
Practice Address - Phone:405-330-3570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK358133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK358OtherSTATE LICENSE
OK731587752OtherTAX I.D. NUMBER
OK386503OtherREGISTRATION NUMBER