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General NPI Number Information
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NPI Number | 1497059406
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Entity Type | Individual
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Provider Name | AMMAR KHASHAN PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/05/2011
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Last Update Date | 03/24/2020
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Provider Practice Location Address
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Address Line | 3910 VISTA WAY STE 106
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City | OCEANSIDE
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State | CA
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Zip | 92056-4513
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Country | US
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Telephone | 760-941-2000
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Fax | 760-941-4900
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Provider Business Mailing Address
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Address Line | 710 COMMERCE DR STE 200
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City | WOODBURY
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State | MN
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Zip | 55125-4925
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Country | US
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Telephone | 651-968-5050
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Fax | 651-968-5900
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1521
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10880
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 56687
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License Number State | CA
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