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General NPI Number Information
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NPI Number | 1134119894
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Entity Type | Individual
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Provider Name | ASHRAF ALI KHAN MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 1245 WILSHIRE BLVD STE 316
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City | LOS ANGELES
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State | CA
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Zip | 90017-4803
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Country | US
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Telephone | 213-250-5005
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Fax | 213-250-5004
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Provider Business Mailing Address
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Address Line | 3371 GLENDALE BLVD # 189
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City | LOS ANGELES
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State | CA
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Zip | 90039-1825
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Country | US
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Telephone | 323-661-8817
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Fax | 323-661-8817
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A64107
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License Number State | CA
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