Basic Information
| Provider Information | |||||||||
| NPI: | 1669008868 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHALSA | ||||||||
| FirstName: | KARAMBIR | ||||||||
| MiddleName: | SINGH | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 RED CLIFFS D6R. | ||||||||
| Address2: | STE 4B PMB 566 | ||||||||
| City: | ST. GEORGE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 847908170 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4353190293 | ||||||||
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| Practice Location | |||||||||
| Address1: | 249 E TABERNACLE ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | ST GEORGE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 847702951 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4357057574 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2020 | ||||||||
| LastUpdateDate: | 03/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | NLC.0107000 | CO | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.