Provider Demographics
NPI:1477020246
Name:KHAN, AHAD U (NP-C)
Entity Type:Individual
Prefix:MR
First Name:AHAD
Middle Name:U
Last Name:KHAN
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15855 POMONA RINCON RD BLDG 4
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-3162
Mailing Address - Country:US
Mailing Address - Phone:909-929-2514
Mailing Address - Fax:
Practice Address - Street 1:15855 POMONA RINCON RD BLDG 4
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-3162
Practice Address - Country:US
Practice Address - Phone:909-929-2514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013514363LF0000X, 363LF0000X
IL209018624363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily