Provider Demographics
NPI:1194927392
Name:KHAN, PARVEEN (MD)
Entity type:Individual
Prefix:DR
First Name:PARVEEN
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PARVEEN
Other - Middle Name:
Other - Last Name:AKHTAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1860 PENNSYLVANIA AVENUE
Mailing Address - Street 2:SUITE #300
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533
Mailing Address - Country:US
Mailing Address - Phone:707-646-4100
Mailing Address - Fax:707-646-4101
Practice Address - Street 1:1860 PENNSYLVANIA AVENUE
Practice Address - Street 2:SUITE #300
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533
Practice Address - Country:US
Practice Address - Phone:707-646-4100
Practice Address - Fax:707-646-4101
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC156111351207V00000X
CAA101696207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology