Provider Demographics
NPI:1073584611
Name:KHAN, FARHA N (MD)
Entity Type:Individual
Prefix:MRS
First Name:FARHA
Middle Name:N
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:515 W BUCKEYE RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85003-2647
Mailing Address - Country:US
Mailing Address - Phone:602-257-9229
Mailing Address - Fax:602-257-9368
Practice Address - Street 1:515 W BUCKEYE RD
Practice Address - Street 2:SUITE 402
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003-2647
Practice Address - Country:US
Practice Address - Phone:480-759-1040
Practice Address - Fax:480-759-3520
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ25174208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ393041Medicaid
AZG74833Medicare UPIN