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General NPI Number Information
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NPI Number | 1346192291
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Entity Type | Organization
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Legal Business Name | KHANDHAR MEDICAL GROUP PC
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 22601 LA PALMA AVE STE 101A
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City | YORBA LINDA
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State | CA
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Zip | 92887-6711
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Country | US
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Telephone | 949-667-4325
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Fax | 949-392-8762
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Provider Business Mailing Address
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Address Line | 22601 LA PALMA AVE STE 101A
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City | YORBA LINDA
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State | CA
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Zip | 92887-6711
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Country | US
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Telephone | 949-667-4325
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Fax | 949-392-8762
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Authorized Official
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Title or Position | OWNER/PRACTICING PHYSICIAN
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Name | SHRUTI KHANDHAR
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Credential | DO
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Telephone | 949-667-4325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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