Healthcare Provider Details

I. General information

NPI: 1821143264
Provider Name (Legal Business Name): BALRAJ SINGH KHEHRA P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2390 E FLORIDA AVE STE 201
HEMET CA
92544-4754
US

IV. Provider business mailing address

2390 E FLORIDA AVE STE 201
HEMET CA
92544-4754
US

V. Phone/Fax

Practice location:
  • Phone: 951-237-8304
  • Fax:
Mailing address:
  • Phone: 951-237-8304
  • Fax: 951-777-5399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT29052
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: