Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1245380880 |
---|---|
Provider Name | Dr. Khwaja S. Alim |
First Address | La Jolla, CA 92037-5149 |
Second Address | La Jolla, CA 92037-5149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 06/08/2014 |