Provider Demographics
NPI:1982316287
Name:KHAN, TAMSEEL
Entity Type:Individual
Prefix:
First Name:TAMSEEL
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6370 STONERIDGE MALL RD APT I215
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-8062
Mailing Address - Country:US
Mailing Address - Phone:510-565-2481
Mailing Address - Fax:
Practice Address - Street 1:300 ILENE ST
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-2631
Practice Address - Country:US
Practice Address - Phone:925-655-0567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker