MEDICARE: DR. JAGMOHAN SINGH KHAIRA 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
1	207R00000X	Internal Medicine Physician	A81083	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	A81038	OTHER	CA	CALIFORNIA LICENSE NUMBER

General Provider Information

NPI Number	:	1801864988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAGMOHAN SINGH KHAIRA M.D.

Provider Business Mailing Address
First Line	:	1050 MARINA VILLAGE PKWY
Second Line	:	STE 101
City	:	ALAMEDA
State	:	CA
Zip	:	94501-1033
Country	:	US
Telephone Number	:	510-227-5540
Fax Number	:	510-788-6849

Provider Business Practice Location Address
First Line	:	1050 MARINA VILLAGE PARKWAY
Second Line	:	SUITE 101
City	:	ALAMEDA
State	:	CA
Zip	:	94501-1033
Country	:	US
Telephone Number	:	510-227-5540
Fax Number	:	510-373-2339

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	01/28/2020

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