Provider Demographics
NPI:1164684007
Name:KHAN, KAMRAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMRAN
Middle Name:A
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 30220
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89173-0220
Mailing Address - Country:US
Mailing Address - Phone:586-482-8605
Mailing Address - Fax:702-737-1402
Practice Address - Street 1:5770 S DURANGO DR STE 105
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-2311
Practice Address - Country:US
Practice Address - Phone:586-482-8605
Practice Address - Fax:702-737-1402
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12751207R00000X, 207RP1001X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVAN510YMedicare PIN