MEDICARE: RAVINDER SINGH KHAIRA 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
1	208000000X	Pediatrics Physician	A056390	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

General Provider Information

NPI Number	:	1902842354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAVINDER SINGH KHAIRA MD

Provider Business Mailing Address
First Line	:	4617 FREEPORT BLVD
Second Line	:	SUITE B
City	:	SACRAMENTO
State	:	CA
Zip	:	95822
Country	:	US
Telephone Number	:	916-422-7273
Fax Number	:	916-422-2127

Provider Business Practice Location Address
First Line	:	4617 FREEPORT BLVD STE B
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95822-2015
Country	:	US
Telephone Number	:	916-422-7273
Fax Number	:	916-422-2127

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	09/01/2017

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