MEDICARE: DR. MELVIN KHAW M.D.

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	207RI0200X	Infectious Disease Physician	G70617	CA
2	207R00000X	Internal Medicine Physician	G70617	CA

General Provider Information

NPI Number	:	1487624045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELVIN KHAW M.D.

Provider Business Mailing Address
First Line	:	16030 VENTURA BLVD
Second Line	:	SUITE 680
City	:	ENCINO
State	:	CA
Zip	:	91436-2731
Country	:	US
Telephone Number	:	818-990-1067
Fax Number	:	818-981-1217

Provider Business Practice Location Address
First Line	:	16030 VENTURA BLVD
Second Line	:	SUITE 680
City	:	ENCINO
State	:	CA
Zip	:	91436-2731
Country	:	US
Telephone Number	:	818-990-1067
Fax Number	:	818-981-1217

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	02/20/2020

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