Healthcare Provider Details

I. General information

NPI: 1841446010
Provider Name (Legal Business Name): HARNEK SINGH KAHLON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2008
Last Update Date: 02/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PRISON RD
REPRESA CA
95671-3001
US

IV. Provider business mailing address

PO BOX 290012
REPRESA CA
95671-0012
US

V. Phone/Fax

Practice location:
  • Phone: 916-985-8610
  • Fax:
Mailing address:
  • Phone: 916-985-8610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA121508
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberA121508
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: