Provider Demographics
NPI:1932968369
Name:KHAKWANI AND MOHAMMAD MEDICAL PC
Entity Type:Organization
Organization Name:KHAKWANI AND MOHAMMAD MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-221-5944
Mailing Address - Street 1:2460 PASEO VERDE PKWY STE 145
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7142
Mailing Address - Country:US
Mailing Address - Phone:702-820-5713
Mailing Address - Fax:
Practice Address - Street 1:1310 E MCKELLIPS RD # 105B
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-2722
Practice Address - Country:US
Practice Address - Phone:480-690-6959
Practice Address - Fax:480-447-7235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty