MEDICARE: MRS. KAVALJIT K CHAHAL N.P.

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	363L00000X	Nurse Practitioner	NP22415	CA

General Provider Information

NPI Number	:	1831436534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAVALJIT K CHAHAL N.P.

Provider Business Mailing Address
First Line	:	24302 PASEO DE VALENCIA
Second Line	:	STE 200
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3115
Country	:	US
Telephone Number	:	562-477-2750
Fax Number	:

Provider Business Practice Location Address
First Line	:	24302 PASEO DE VALENCIA
Second Line	:	SUITE 200
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-3115
Country	:	US
Telephone Number	:	949-458-8252
Fax Number	:	949-588-8252

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

Provider Enumeration Date	:	01/15/2013
Last Update Date	:	04/08/2016

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