Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | A54411 | CA |
NPI | 1033210497 |
---|---|
Provider Name | Rupdev S Khosa |
First Address | Arcadia, CA 91007-7360 |
Second Address | Arcadia, CA 91007-7360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 04/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A4544110 | BC/BS (01) | CA |
00A544110 | (05) | CA |
250011214 | RAILROAD (01) | CA |
G94748 | (02) | CA |