Provider Demographics
NPI:1043437874
Name:KHALIF, AYAAN HEIS
Entity Type:Individual
Prefix:
First Name:AYAAN
Middle Name:HEIS
Last Name:KHALIF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7594 PARK RIDGE BLVD UNIT 14
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-2235
Mailing Address - Country:US
Mailing Address - Phone:619-567-6873
Mailing Address - Fax:
Practice Address - Street 1:1905 TERRACINA CIR
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-3544
Practice Address - Country:US
Practice Address - Phone:619-295-6067
Practice Address - Fax:619-295-6047
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator