Provider Demographics
NPI:1720668254
Name:FIRST OPINION HEALTH SERVICES (NC), PLLC
Entity Type:Organization
Organization Name:FIRST OPINION HEALTH SERVICES (NC), PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHOSLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-635-8281
Mailing Address - Street 1:630 LOS TRANCOS RD
Mailing Address - Street 2:
Mailing Address - City:PORTOLA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94028-8028
Mailing Address - Country:US
Mailing Address - Phone:805-635-8281
Mailing Address - Fax:
Practice Address - Street 1:1101 DECLARATION DR
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874-8745
Practice Address - Country:US
Practice Address - Phone:309-310-1693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty