Provider Demographics
NPI:1083592422
Name:NAHAL, KOMAL PREET
Entity type:Individual
Prefix:
First Name:KOMAL PREET
Middle Name:
Last Name:NAHAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 BRIDGEPORT AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:CA
Mailing Address - Zip Code:95334-9215
Mailing Address - Country:US
Mailing Address - Phone:209-631-4307
Mailing Address - Fax:
Practice Address - Street 1:911 E TUOLUMNE RD
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-1543
Practice Address - Country:US
Practice Address - Phone:209-668-4101
Practice Address - Fax:209-668-3758
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036608363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily