Provider Demographics
NPI:1972692531
Name:KHURANA, SNEH (MD)
Entity type:Individual
Prefix:
First Name:SNEH
Middle Name:
Last Name:KHURANA
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 1:1400 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-2321
Mailing Address - Country:US
Mailing Address - Phone:714-541-6815
Mailing Address - Fax:714-541-8032
Practice Address - Street 1:1400 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-2321
Practice Address - Country:US
Practice Address - Phone:714-541-6815
Practice Address - Fax:714-541-8032
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42221208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A422210Medicaid
F51926Medicare UPIN
CA00A422210Medicaid