Provider Demographics
NPI:1851492268
Name:ARIF, KHURAM (MD)
Entity Type:Individual
Prefix:
First Name:KHURAM
Middle Name:
Last Name:ARIF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:916-667-0600
Mailing Address - Fax:916-683-0232
Practice Address - Street 1:632 W GIBSON RD
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-5169
Practice Address - Country:US
Practice Address - Phone:530-668-2600
Practice Address - Fax:530-661-1081
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88947208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1431077OtherCIGNA
CAA88947OtherBLUE CROSS
CA00A889470Medicaid
CA108714OtherHEALTH NET
CA2336394OtherUNITED HEALTHCARE
CA1838745OtherGREAT WEST
CA5595387OtherFIRST HEALTH
CA000810524161OtherPHCS
CA246104OtherINTERPLAN
CA7312492OtherAETNA
CA90145135OtherPACIFICARE
CAMCMG375000OtherWESTERN HEALTH ADVANTAGE
CA00A889470OtherBLUE SHIELD
CAA88947OtherBLUE CROSS
CA246104OtherINTERPLAN