Provider Demographics
NPI:1336227594
Name:HANJAN, HARBHAJAN KALSI (MD)
Entity Type:Individual
Prefix:
First Name:HARBHAJAN
Middle Name:KALSI
Last Name:HANJAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HARBHAJAN
Other - Middle Name:
Other - Last Name:KALSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:906 SOUTH SUNSET AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3400
Mailing Address - Country:US
Mailing Address - Phone:626-962-4474
Mailing Address - Fax:626-851-9192
Practice Address - Street 1:906 SOUTH SUNSET AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3400
Practice Address - Country:US
Practice Address - Phone:626-962-4474
Practice Address - Fax:626-851-9192
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38002208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A380020Medicaid