Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A75616 | CA |
N | 111NI0900X | Internist | A75616 | CA |
Y | 207RH0002X | Hospice and Palliative Medicine | A75616 | CA |
NPI | 1396759536 |
---|---|
Provider Name | Mahmood A Khan |
First Address | Claremont, CA 91711-0788 |
Second Address | Pomona, CA 91767-2918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 21/03/2017 |