Healthcare Provider Details

I. General information

NPI: 1649714601
Provider Name (Legal Business Name): SLEEP & CHILDREN PULMONARY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2016
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 S EUCLID AVE
PASADENA CA
91101-2717
US

IV. Provider business mailing address

241 S EUCLID AVE
PASADENA CA
91101-2717
US

V. Phone/Fax

Practice location:
  • Phone: 626-460-8850
  • Fax: 844-287-9296
Mailing address:
  • Phone: 626-460-8850
  • Fax: 844-287-9296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberA121566
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License NumberA121566
License Number StateCA

VIII. Authorized Official

Name: DR. SALMAN KHAN
Title or Position: PRESIDENT
Credential: MD
Phone: 626-787-1060