NPIMap

Individual provider Active NPI

Surjit Kaur Kahlon, M.D.

  • Specialist
  • Upland, CA
National Provider Identifier
1790719623
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A31422 Issued in CA
Practice address
630 N 13TH Ave
Suite B
Upland, CA 91786-4975
Phone
(909) 982-2719
Fax
(909) 946-9931
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A31422 CA Primary

Addresses

Primary practice location

630 N 13TH Ave
Suite B
Upland, CA 91786-4975

Mailing address

630 N 13TH Ave
Suite B
Upland, CA 91786-4975
Phone (909) 982-2719

Other identifiers 1

IdentifierTypeStateIssuer
00A314221MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090112000412 CA Practitioner - Neurology 4688737083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Neurology Group IncGroup PAC ID 1052544152, 19 clinicians

Practice addresses (Care Compare)

2895 N Towne Ave
Pomona, CA 91767-2009
Phone (909) 267-7495

630 N 13TH Ave
Suite B
Upland, CA 91786-4978
Phone (909) 982-2719

Hospital & facility affiliations

  • Pomona Valley Hospital Medical Center Hospital, Pomona, CA, CCN 050231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A31422CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Redlands Community Hospital Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: surjit.kahlon.1@29399.direct.athenahealth.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1790719623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 N 13TH AVE",
            "address_2": "SUITE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864975",
            "telephone_number": "909-982-2719",
            "fax_number": "909-946-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N 13TH AVE",
            "address_2": "SUITE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864975",
            "telephone_number": "909-982-2719",
            "fax_number": "909-946-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHLON",
        "first_name": "SURJIT",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A31422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A314221",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.