Organization
KHUSHAL A STANISAI, MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY E LAMOUREUX (ADMINISTRATOR)
(909) 796-7803
Entity
Organization
Contact information
Practice address
10408 INDUSTRIAL CIR, REDLANDS, CA 92374-4548
(909) 796-0363
(909) 796-0762
Mailing address
10408 INDUSTRIAL CIR, REDLANDS, CA 92374-4548
(909) 796-0363
(909) 796-0762
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A30298
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A302982
—
CA
01
—
110089935
RAILROAD MEDICARE
—
Enumeration date
02/01/2007
Last updated
08/23/2011
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