Provider Demographics
NPI:1184987927
Name:KHAN, YUSRA (MD)
Entity type:Individual
Prefix:DR
First Name:YUSRA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:498 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-2070
Mailing Address - Country:US
Mailing Address - Phone:951-943-8899
Mailing Address - Fax:519-434-5989
Practice Address - Street 1:498 W 4TH ST
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-2070
Practice Address - Country:US
Practice Address - Phone:519-438-8999
Practice Address - Fax:951-943-4598
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09639100208M00000X
CAC168367208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist