Provider Demographics
NPI:1821774589
Name:KHAN, MOHAMMAD AQIB (NREMT)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:AQIB
Last Name:KHAN
Suffix:
Gender:M
Credentials:NREMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9819 MILAN DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-3512
Mailing Address - Country:US
Mailing Address - Phone:209-518-5265
Mailing Address - Fax:
Practice Address - Street 1:9819 MILAN DR
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95212-3512
Practice Address - Country:US
Practice Address - Phone:209-518-5265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)