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General NPI Number Information
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NPI Number | 1750651543
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Entity Type | Organization
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Legal Business Name | NASREEN BABU-KHAN MD A PROF CORP
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 01/10/2012
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Provider Practice Location Address
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Address Line | 970 MONUMENT ST STE 114
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-3874
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Country | US
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Telephone | 310-454-5915
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Fax | 310-454-5027
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Provider Business Mailing Address
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Address Line | 970 MONUMENT ST STE 114
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-3874
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Country | US
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Telephone | 310-454-5915
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Fax | 310-454-5027
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Authorized Official
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Title or Position | OWNER
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Name | DR. NASREEN BABU-KHAN
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Credential | MD
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Telephone | 310-454-5915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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