1801961750 NPI number — DR. RAHUL KHURANA MD

Table of content: DR. RAHUL KHURANA MD (NPI 1801961750)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801961750 NPI number — DR. RAHUL KHURANA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KHURANA
Provider First Name:
RAHUL
Provider Middle Name:
Provider Name Prefix Text:
DR.
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:
1801961750
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 84316
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98116-5616
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
920-550-1893
Provider Business Mailing Address Fax Number:
206-899-1545

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 BOREN AVE
Provider Second Line Business Practice Location Address:
SUITE 701
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98104-3508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-550-1893
Provider Business Practice Location Address Fax Number:
206-899-1545
Provider Enumeration Date:
11/22/2006

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: 2084P0800X , with the licence number:  MD000046271 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10153372 . This is a "REGENCE BLUE SHIELD" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 80731038 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: HPW68 . This is a "BLUE CROSS OF IDAHO IND" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 7046543 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 807310300 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".




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