Healthcare Provider Details

I. General information

NPI: 1801470778
Provider Name (Legal Business Name): NAVEERA KHAN MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2021
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 SW RAMSEY AVE STE 201
GRANTS PASS OR
97527-5535
US

IV. Provider business mailing address

2825 E BARNETT RD
MEDFORD OR
97504-8332
US

V. Phone/Fax

Practice location:
  • Phone: 541-789-4505
  • Fax:
Mailing address:
  • Phone: 541-789-4281
  • Fax: 541-789-4806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD228002
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: