MEDICARE: DR. LUBNA KHAN MD

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	207Q00000X	Family Medicine Physician	49768	WI
2	207Q00000X	Family Medicine Physician	12904	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	12904	OTHER	NV	STATE LICENSE

General Provider Information

NPI Number	:	1417033044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUBNA KHAN MD

Provider Business Mailing Address
First Line	:	2350 CORPORATE CIR STE 200
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7737
Country	:	US
Telephone Number	:	702-436-7700
Fax Number	:	702-436-3800

Provider Business Practice Location Address
First Line	:	100 N GREEN VALLEY PKWY STE 110
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-6392
Country	:	US
Telephone Number	:	702-436-7700
Fax Number	:	702-436-3800

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	02/09/2026

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