Provider Demographics
NPI:1124092549
Name:KHAN, RAHIL RASHID (MD)
Entity type:Individual
Prefix:DR
First Name:RAHIL
Middle Name:RASHID
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 ALTON PARKWAY
Mailing Address - Street 2:STE 101
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-3812
Mailing Address - Country:US
Mailing Address - Phone:949-222-2722
Mailing Address - Fax:949-222-9969
Practice Address - Street 1:2500 ALTON PKWY STE 101
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-5032
Practice Address - Country:US
Practice Address - Phone:949-222-2722
Practice Address - Fax:949-222-9969
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62362207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635686OtherBC/BS PROVIDER #
IL01635686OtherBC/BS PROVIDER #
IL212553Medicare ID - Type UnspecifiedMEDICARE GROUP #