Provider Demographics
NPI:1376114371
Name:KHAN, OSAMA AHMED (MD)
Entity Type:Individual
Prefix:DR
First Name:OSAMA
Middle Name:AHMED
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3199 MADERNA ROAD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L7M2W4
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DRIVE DEPARTMENT OF PATHOLOGY RM L235
Practice Address - Street 2:C/O GABBY BARELA
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-5252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program