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NPI Code Detail

MEDICARE: MS. AMRIT KAUR KHALSA RN IBCLC

MEDICARE:  MS. AMRIT KAUR KHALSA  RN IBCLC
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
1163W00000XRegistered Nurse222732CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
168-0480927OTHERCALACTATION NURSE SPECIALIST

General Provider Information

NPI Number : 1477924959
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMRIT KAUR KHALSA RN IBCLC
Provider Business Mailing Address
First Line : 2218 LAWRENCE ST
Second Line :
City : EL CERRITO
State : CA
Zip : 94530-2734
Country : US
Telephone Number : 510-235-4878
Fax Number :
Provider Business Practice Location Address
First Line : 2218 LAWRENCE ST
Second Line :
City : EL CERRITO
State : CA
Zip : 94530
Country : US
Telephone Number : 510-235-4878
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2015
Last Update Date : 10/09/2015

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