Provider Demographics
NPI:1184695165
Name:KAHLON, MANINDER SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:MANINDER
Middle Name:SINGH
Last Name:KAHLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13640 N 99TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-0001
Mailing Address - Country:US
Mailing Address - Phone:623-322-5700
Mailing Address - Fax:623-328-9181
Practice Address - Street 1:13640 N 99TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-0001
Practice Address - Country:US
Practice Address - Phone:623-322-5700
Practice Address - Fax:623-328-9181
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ230742084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ73946Medicare ID - Type Unspecified
AZF46329Medicare UPIN