MEDICARE: DR. FARHAN KHAN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	OS016599	PA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207P00000X	Emergency Medicine Physician	OS016599	PA

General Provider Information

NPI Number	:	1013251347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARHAN KHAN DO

Provider Business Mailing Address
First Line	:	3903 CITY AVE
Second Line	:	APT C710
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-2911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4190 CITY AVE STE 315
Second Line	:	DEPARTMENT OF SURGERY
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-1633
Country	:	US
Telephone Number	:	215-871-6942
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2012
Last Update Date	:	03/24/2020

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