Provider Demographics
NPI:1174263503
Name:IMRAN AZIZ KHAN INC
Entity Type:Organization
Organization Name:IMRAN AZIZ KHAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:IMRAN
Authorized Official - Middle Name:AZIZ
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-944-6982
Mailing Address - Street 1:556 S FAIR OAKS AVE # 599
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2656
Mailing Address - Country:US
Mailing Address - Phone:213-944-6982
Mailing Address - Fax:
Practice Address - Street 1:556 S FAIR OAKS AVE # 599
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2656
Practice Address - Country:US
Practice Address - Phone:213-944-6982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty