Provider Demographics
NPI:1750983235
Name:KHAN, MAHPARA (OTR/L)
Entity type:Individual
Prefix:
First Name:MAHPARA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1746 N ORANGE DR APT 1203
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-4366
Mailing Address - Country:US
Mailing Address - Phone:586-804-2356
Mailing Address - Fax:
Practice Address - Street 1:1746 N ORANGE DR APT 1203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-4366
Practice Address - Country:US
Practice Address - Phone:586-804-2356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19844225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist