Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | A66762 | CA |
NPI | 1013095777 |
---|---|
Provider Name | Amer H. Khan |
First Address | Roseville, CA 95661-3851 |
Second Address | Roseville, CA 95661-3851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 02/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A667620 | (05) | CA |
G16110 | (02) |