Provider Demographics
NPI:1548605843
Name:KHAN, FAHAD HABIB (MD)
Entity Type:Individual
Prefix:DR
First Name:FAHAD
Middle Name:HABIB
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:233 LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2122
Mailing Address - Country:US
Mailing Address - Phone:619-501-9050
Mailing Address - Fax:619-501-9054
Practice Address - Street 1:233 LEWIS ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2122
Practice Address - Country:US
Practice Address - Phone:619-501-9050
Practice Address - Fax:619-501-9054
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA163142207W00000X, 207WX0009X
IL036145222207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology