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General NPI Number Information
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NPI Number | 1558633230
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Entity Type | Individual
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Provider Name | AMIR T KHAN PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2012
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 2339 W HAMMER LN STE J
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City | STOCKTON
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State | CA
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Zip | 95209-2368
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Country | US
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Telephone | 209-471-7100
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Fax | 209-471-7111
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Provider Business Mailing Address
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Address Line | 5863 SAINT ANDREWS DR
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City | STOCKTON
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State | CA
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Zip | 95219-1930
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Country | US
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Telephone | 209-471-5426
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Fax | 209-477-7111
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14304
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 51125
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License Number State | CA
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