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NPI Code Detail

MEDICARE: DR. KUNWAR KHALSA M.D.

MEDICARE: DR. KUNWAR KHALSA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician56118AZ
2207XS0117XOrthopaedic Surgery of the Spine Physician56118AZ

General Provider Information

NPI Number : 1417377201
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KUNWAR KHALSA M.D.
Provider Business Mailing Address
First Line : PO BOX 80217
Second Line :
City : PHOENIX
State : AZ
Zip : 85060-0217
Country : US
Telephone Number : 602-385-2115
Fax Number : 602-772-3801
Provider Business Practice Location Address
First Line : 5355 E HIGH ST UNIT 113
Second Line :
City : PHOENIX
State : AZ
Zip : 85054-5481
Country : US
Telephone Number : 602-648-5444
Fax Number : 602-772-3801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2014
Last Update Date : 06/16/2026

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