Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | OS11890 | FL |
Y | 207KA0200X | Allergist | 20A13876 | CA |
N | 207RA0201X | Internist - Allergy & Immunology | OS11890 | FL |
NPI | 1851553424 |
---|---|
Provider Name | Dr. Javaid M. Khan |
First Address | Fresno, CA 93720-2457 |
Second Address | Fresno, CA 93720-2457 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2008 |
Last Update Date | 17/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GR0043790 | (05) | CA |
ZZZ21572Z | BAZ ALLERGY, ASTHMA & SINUS CENTER GRP PTAN (01) | CA |