1710901202 NPI number — CHARANJIT S KHURANA MD

Table of content: CHARANJIT S KHURANA MD (NPI 1710901202)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710901202 NPI number — CHARANJIT S KHURANA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHURANA
Provider First Name:
CHARANJIT
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710901202
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1715 N GEORGE MASON DR
Provider Second Line Business Mailing Address:
STE 107
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22205
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-527-1400
Provider Business Mailing Address Fax Number:
703-225-0043

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1715 N GEORGE MASON DR
Provider Second Line Business Practice Location Address:
STE 107
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-527-1400
Provider Business Practice Location Address Fax Number:
703-225-0043
Provider Enumeration Date:
07/27/2006

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: 207RC0000X , with the licence number:  0101235014 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0011X , with the licence number: 0101235014 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 05149844 . This is a "ECFMG" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com