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General NPI Number Information
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NPI Number | 1285928705
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Entity Type | Individual
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Provider Name | ADNAN KHAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 06/02/2018
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Provider Practice Location Address
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Address Line | 2333 N CALIFORNIA ST
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City | STOCKTON
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State | CA
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Zip | 95204
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Country | US
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Telephone | 209-942-1005
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Fax | 209-942-0455
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Provider Business Mailing Address
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Address Line | 1800 N CALIFORNIA ST STE 14A
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City | STOCKTON
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State | CA
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Zip | 95204-6019
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Country | US
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Telephone | 209-942-1005
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Fax | 209-942-0455
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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 | BP1-0040896
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | BP20049349
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | A141739
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A141739
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License Number State | CA
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