Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | A129432 | CA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | H89660 | MD |
NPI | 1639457260 |
---|---|
Provider Name | Habib Ahmad Khan |
First Address | Ventura, CA 93004-1377 |
Second Address | Ventura, CA 93004-1377 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2011 |
Last Update Date | 30/06/2020 |