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General NPI Number Information
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NPI Number | 1669418182
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Entity Type | Individual
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Provider Name | SIRISAT KAUR KHALSA M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 4849 VAN NUYS BLVD STE 202
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-2121
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Country | US
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Telephone | 310-954-5315
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Fax | 310-496-0430
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Provider Business Mailing Address
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Address Line | 4849 VAN NUYS BLVD STE 202
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-2121
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Country | US
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Telephone | 310-954-5315
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Fax | 310-496-0430
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A75010
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | A75010
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License Number State | CA
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