Provider Demographics
NPI:1619342623
Name:ASAD U KHAJA, M.D., INC.
Entity Type:Organization
Organization Name:ASAD U KHAJA, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASAD
Authorized Official - Middle Name:U
Authorized Official - Last Name:KHAJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-308-3733
Mailing Address - Street 1:22617 HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-2510
Mailing Address - Country:US
Mailing Address - Phone:310-308-3733
Mailing Address - Fax:
Practice Address - Street 1:22617 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-2510
Practice Address - Country:US
Practice Address - Phone:310-308-3733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94996207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty