Provider Demographics
NPI:1093504219
Name:FAWAD ZAFAR-KHAN, MARIAM
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:
Last Name:FAWAD ZAFAR-KHAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:MARIAM
Other - Middle Name:
Other - Last Name:ZAFAR-KHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4733 W SUNSET BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4733 W SUNSET BLVD FL 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6021
Practice Address - Country:US
Practice Address - Phone:800-438-1117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program