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NPI Code Detail

MEDICARE: KOMAL KAUR PORDAL MD

MEDICARE: KOMAL KAUR PORDAL MD
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
12084P0800XPsychiatry Physician27328NV

General Provider Information

NPI Number : 1669058400
Entity Type Code : Individual
Provider Name (Legal Business Name) : KOMAL KAUR PORDAL MD
Provider Business Mailing Address
First Line : 6600 W CHARLESTON BLVD STE 142
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-1050
Country : US
Telephone Number : 702-440-8430
Fax Number :
Provider Business Practice Location Address
First Line : 6600 W CHARLESTON BLVD STE 142
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-1050
Country : US
Telephone Number : 702-440-8430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2021
Last Update Date : 06/04/2025

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Directions to “ KOMAL KAUR PORDAL MD” Practice Location

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