Provider Demographics
NPI:1104835909
Name:AZIZ A KHAN,M.D.INC
Entity Type:Organization
Organization Name:AZIZ A KHAN,M.D.INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AZIZ
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-945-2655
Mailing Address - Street 1:9200 COLIMA RD STE 302
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-1814
Mailing Address - Country:US
Mailing Address - Phone:562-945-2655
Mailing Address - Fax:562-696-2414
Practice Address - Street 1:9200 COLIMA RD STE 302
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-1814
Practice Address - Country:US
Practice Address - Phone:562-945-2655
Practice Address - Fax:562-696-2414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24865208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24865Medicaid
A83123Medicare UPIN
A24865Medicare ID - Type Unspecified