Provider Demographics
NPI:1063915825
Name:KHOSA, JASKIRAN KAUR (MD)
Entity type:Individual
Prefix:
First Name:JASKIRAN
Middle Name:KAUR
Last Name:KHOSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4234 RIVERWALK PKWY STE 230
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3312
Mailing Address - Country:US
Mailing Address - Phone:951-781-3672
Mailing Address - Fax:951-781-0365
Practice Address - Street 1:4234 RIVERWALK PKWY STE 230
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3312
Practice Address - Country:US
Practice Address - Phone:951-781-3672
Practice Address - Fax:951-781-0365
Is Sole Proprietor?:No
Enumeration Date:2018-03-17
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA174085207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine