Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | A110206 | CA |
Y | 207Q00000X | Family Doctor | A110206 | CA |
N | 207QA0401X | Family Doctor - Addiction Medicine | A110206 | CA |
N | 207VX0000X | Obstetrician | A110206 | CA |
NPI | 1801059555 |
---|---|
Provider Name | Dr. Tipu Vahid Khan |
First Address | Ventura, CA 93003-3099 |
Second Address | Ventura, CA 93003-3099 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 19/09/2016 |