Basic Information
| Provider Information | |||||||||
| NPI: | 1699827873 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZAFAR-KHAN | ||||||||
| FirstName: | FAWAD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2878 | ||||||||
| Address2: | |||||||||
| City: | VENICE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902942878 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188179832 | ||||||||
| FaxNumber: | 8188179835 | ||||||||
| Practice Location | |||||||||
| Address1: | 2021 SANTA MONICA BLVD | ||||||||
| Address2: | SUITE 710E | ||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904042208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188179832 | ||||||||
| FaxNumber: | 8188179835 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2007 | ||||||||
| LastUpdateDate: | 06/17/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | A61984 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.