1891916771 NPI number — UMINDER KAUR CHAHAL RDN, LDN

Table of content: UMINDER KAUR CHAHAL RDN, LDN (NPI 1891916771)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891916771 NPI number — UMINDER KAUR CHAHAL RDN, LDN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAHAL
Provider First Name:
UMINDER
Provider Middle Name:
KAUR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RDN, LDN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHAHAL
Provider Other First Name:
UMI
Provider Other Middle Name:
K
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
R.D., L.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1891916771
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/26/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3033 NW 63RD ST STE 250
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73116-3633
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-879-3470
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15208 BURNING SPRING RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDMOND
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73013-1321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-330-3570
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  358 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 358 . This is a "STATE LICENSE" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".
  • Identifier: 731587752 . This is a "TAX I.D. NUMBER" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".
  • Identifier: 386503 . This is a "REGISTRATION NUMBER" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".




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