Healthcare Provider Details

I. General information

NPI: 1497675102
Provider Name (Legal Business Name): SAT KARTAR KHALSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 OFFICE COURT DR STE 603
SANTA FE NM
87507-4905
US

IV. Provider business mailing address

2221 RIO GRANDE BLVD NW
ALBUQUERQUE NM
87104-2529
US

V. Phone/Fax

Practice location:
  • Phone: 505-310-4764
  • Fax: 505-467-8338
Mailing address:
  • Phone: 505-830-1971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: