Provider Demographics
NPI:1710593165
Name:KHAN, AMIR (LMT)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25935 ROLLING HILLS RD APT 334
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-7252
Mailing Address - Country:US
Mailing Address - Phone:646-656-0036
Mailing Address - Fax:
Practice Address - Street 1:25935 ROLLING HILLS RD APT 334
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-7252
Practice Address - Country:US
Practice Address - Phone:646-656-0036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75752225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist