MEDICARE: KHASIM H. KHAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083X0100X	Occupational Medicine Physician	A32797	CA

General Provider Information

NPI Number	:	1063560878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHASIM H. KHAN MD

Provider Business Mailing Address
First Line	:	441 N LAKEVIEW AVE
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92807-3028
Country	:	US
Telephone Number	:	888-988-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	441 N LAKEVIEW AVE
Second Line	:
City	:	ANAHEIM
State	:	CA
Zip	:	92807-3028
Country	:	US
Telephone Number	:	888-988-2800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	12/28/2025

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