Provider Demographics
NPI:1043799158
Name:KHAN, MOHAMMAD MUHIB (PT)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:MUHIB
Last Name:KHAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 CALLOWAY DR STE 603
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2514
Mailing Address - Country:US
Mailing Address - Phone:661-377-1700
Mailing Address - Fax:661-616-9199
Practice Address - Street 1:7900 DISTRICT BLVD UNIT A
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-4845
Practice Address - Country:US
Practice Address - Phone:661-377-1700
Practice Address - Fax:661-616-9199
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT296529225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty