Basic Information
| Provider Information | |||||||||
| NPI: | 1013361427 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHAN | ||||||||
| FirstName: | IMRAN | ||||||||
| MiddleName: | SAEED | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 16TH ST | ||||||||
| Address2: | 4TH FLOOR, 4551, BOX 0110 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941432549 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 550 16TH ST | ||||||||
| Address2: | 4TH FLOOR, 4551, BOX 0110 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941432549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154766245 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2016 | ||||||||
| LastUpdateDate: | 08/21/2018 | ||||||||
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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 | 208000000X | 156254 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.