Provider Demographics
NPI:1881256550
Name:KHIAR, IMAN (PA-C)
Entity type:Individual
Prefix:
First Name:IMAN
Middle Name:
Last Name:KHIAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4218 MONTEREY RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90032-1441
Mailing Address - Country:US
Mailing Address - Phone:408-892-0633
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE BLDG 27
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-1441
Practice Address - Country:US
Practice Address - Phone:408-892-0633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant