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General NPI Number Information
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NPI Number | 1568996338
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Entity Type | Individual
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Provider Name | TALHA M KHAN MD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 19712 MACARTHUR BLVD STE 100
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City | IRVINE
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State | CA
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Zip | 92612-2407
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Country | US
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Telephone | 949-486-8530
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Fax | 949-486-8531
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Provider Business Mailing Address
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Address Line | 19712 MACARTHUR BLVD STE 100
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City | IRVINE
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State | CA
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Zip | 92612-2407
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Country | US
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Telephone | 949-486-8530
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Fax | 949-486-8531
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | MD472566
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | A195411
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License Number State | CA
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