Provider Demographics
NPI:1780700930
Name:KHANDAN-ALAI, GOLI (CRNA)
Entity type:Individual
Prefix:
First Name:GOLI
Middle Name:
Last Name:KHANDAN-ALAI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18311 THOMAS CIR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-1552
Mailing Address - Country:US
Mailing Address - Phone:714-721-2298
Mailing Address - Fax:
Practice Address - Street 1:18311 THOMAS CIR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-1552
Practice Address - Country:US
Practice Address - Phone:714-721-2298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA3219367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered