Healthcare Provider Details

I. General information

NPI: 1922585777
Provider Name (Legal Business Name): HUMA KHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HUMA MAJEEDULLAH KHAN MD

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6644 LONETREE BLVD STE 300
ROCKLIN CA
95765-4432
US

IV. Provider business mailing address

6644 LONETREE BLVD STE 300
ROCKLIN CA
95765-4432
US

V. Phone/Fax

Practice location:
  • Phone: 916-721-2977
  • Fax:
Mailing address:
  • Phone: 916-721-2977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD479232
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA205781
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberHS000012
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberHS000012
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: