Provider Demographics
NPI:1518371194
Name:KHOSLA, MANRAJ SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:MANRAJ
Middle Name:SINGH
Last Name:KHOSLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23861 MCBEAN PKWY STE A1
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2003
Mailing Address - Country:US
Mailing Address - Phone:661-288-5700
Mailing Address - Fax:661-288-5703
Practice Address - Street 1:23861 MCBEAN PKWY STE A1
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2003
Practice Address - Country:US
Practice Address - Phone:661-288-5700
Practice Address - Fax:661-288-5703
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-11
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA148854207R00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine