Healthcare Provider Details

I. General information

NPI: 1447349006
Provider Name (Legal Business Name): ASMA MASOOD KHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 11/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17660 LAKEWOOD BOULEVARD
BELLFLOWER CA
90706-6410
US

IV. Provider business mailing address

17660 LAKEWOOD BLVD
BELLFLOWER CA
90706-6410
US

V. Phone/Fax

Practice location:
  • Phone: 562-461-1179
  • Fax: 562-804-0862
Mailing address:
  • Phone: 562-424-6200
  • Fax: 562-804-0865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA48900
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: