Basic Information
Provider Information
NPI: 1699017327
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KHULLAR
FirstName: AASHISH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3299
Address2:  
City: CARSON CITY
State: NV
PostalCode: 897023299
CountryCode: US
TelephoneNumber: 7752220044
FaxNumber: 8887000187
Practice Location
Address1: 235 W 6TH ST
Address2:  
City: RENO
State: NV
PostalCode: 895034548
CountryCode: US
TelephoneNumber: 7757706490
FaxNumber: 7757703944
Other Information
ProviderEnumerationDate: 03/20/2013
LastUpdateDate: 03/12/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000XA145528CAN Allopathic & Osteopathic PhysiciansHospitalist 
207R00000X16582NVY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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