Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | A60839 | CA |
NPI | 1093721672 |
---|---|
Provider Name | Aman Shabi Khan |
First Address | Daly City, CA 94015-2223 |
Second Address | Daly City, CA 94015-2223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 08/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A608390 | (05) | CA |
0208450001 | MEDICARE NSC GROUP (01) | CA |
200046337 | MEDICARE RAILROAD (01) | CA |
A60839 | STATE (01) | CA |
H62978 | (02) | CA |
ZZZ32209Z | GROUP MEDICARE (01) | CA |