Basic Information
| Provider Information | |||||||||
| NPI: | 1861514531 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHAN | ||||||||
| FirstName: | IMRAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 991901 | ||||||||
| Address2: | |||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960991901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5306054260 | ||||||||
| FaxNumber: | 5306054265 | ||||||||
| Practice Location | |||||||||
| Address1: | 1035 PLACER ST | ||||||||
| Address2: | |||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960011125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302465710 | ||||||||
| FaxNumber: | 5302417838 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2007 | ||||||||
| LastUpdateDate: | 03/11/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | A94558 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 207R00000X | A94558 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.