Healthcare Provider Details

I. General information

NPI: 1720321250
Provider Name (Legal Business Name): KIRANJIT KAUR KHALSA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8575 E PRINCESS DR STE 111
SCOTTSDALE AZ
85255-5437
US

IV. Provider business mailing address

8575 E PRINCESS DR STE 111
SCOTTSDALE AZ
85255-5437
US

V. Phone/Fax

Practice location:
  • Phone: 602-694-3566
  • Fax:
Mailing address:
  • Phone: 602-694-3566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number56717
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: