Provider Demographics
NPI:1720274905
Name:KHALSA, HARI BHAJAN SINGH (DC)
Entity Type:Individual
Prefix:DR
First Name:HARI BHAJAN SINGH
Middle Name:
Last Name:KHALSA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6404 WILSHIRE BLVD
Mailing Address - Street 2:STE 700
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5509
Mailing Address - Country:US
Mailing Address - Phone:310-274-6164
Mailing Address - Fax:310-274-8085
Practice Address - Street 1:6404 WILSHIRE BLVD
Practice Address - Street 2:STE 700
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5509
Practice Address - Country:US
Practice Address - Phone:310-274-6164
Practice Address - Fax:310-274-8085
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC14664Medicare UPIN