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General NPI Number Information
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NPI Number | 1528189842
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Entity Type | Organization
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Legal Business Name | NADEEM TAHIR-KHELI, M.D., INC.
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1805 N CALIFORNIA ST SUITE 201
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City | STOCKTON
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State | CA
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Zip | 95204-6037
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Country | US
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Telephone | 209-939-3840
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Fax |
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Provider Business Mailing Address
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Address Line | 1805 N CALIFORNIA ST SUITE 201
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City | STOCKTON
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State | CA
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Zip | 95204-6037
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Country | US
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Telephone | 209-939-3840
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NADEEM K TAHIR-KHELI
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Credential |
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Telephone | 209-939-3840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A71746
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License Number State | CA
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