Healthcare Provider Details
I. General information
NPI: 1053517490
Provider Name (Legal Business Name): UZMA ANWER REHMAN KHAN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/22/2007
Last Update Date: 10/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2311 LOVERIDGE RD 2ND FLOOR
PITTSBURG CA
94565-5117
US
IV. Provider business mailing address
2311 LOVERIDGE RD 2ND FLOOR
PITTSBURG CA
94565-5117
US
V. Phone/Fax
- Phone: 925-431-2600
- Fax: 925-431-2644
- Phone: 925-431-2600
- Fax: 925-431-2644
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | A100026 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: