Provider Demographics
NPI:1376347757
Name:KHAKH, RAVJOT
Entity type:Individual
Prefix:
First Name:RAVJOT
Middle Name:
Last Name:KHAKH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14764 BRADBURY RD
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:CA
Mailing Address - Zip Code:95315-9730
Mailing Address - Country:US
Mailing Address - Phone:209-585-6138
Mailing Address - Fax:
Practice Address - Street 1:5445 LAUREL HILLS DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-3105
Practice Address - Country:US
Practice Address - Phone:191-660-9510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner