Provider Demographics
NPI:1487022836
Name:NAZIR U KHAJA M D INC
Entity Type:Organization
Organization Name:NAZIR U KHAJA M D INC
Other - Org Name:NAZIR U KHAJA MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAZIR
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-370-4660
Mailing Address - Street 1:23639 HAWTHORNE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-5988
Mailing Address - Country:US
Mailing Address - Phone:310-370-4660
Mailing Address - Fax:310-793-0710
Practice Address - Street 1:23639 HAWTHORNE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5988
Practice Address - Country:US
Practice Address - Phone:310-370-4660
Practice Address - Fax:310-793-0710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24571207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A245710Medicaid
CAA83046Medicare UPIN