Provider Demographics
NPI:1194989418
Name:KHAN, UZMA A (MD)
Entity type:Individual
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First Name:UZMA
Middle Name:A
Last Name:KHAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:757 WESTWOOD PLZ
Mailing Address - Street 2:7501
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-0001
Mailing Address - Country:US
Mailing Address - Phone:310-267-9643
Mailing Address - Fax:310-267-3840
Practice Address - Street 1:1225 15TH ST
Practice Address - Street 2:A454
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1101
Practice Address - Country:US
Practice Address - Phone:310-319-4698
Practice Address - Fax:310-319-4908
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2021-12-03
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Provider Licenses
StateLicense IDTaxonomies
CAA100425208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1194989418Medicaid
CA1194989418Medicaid