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Organization
TARIQ ALI KHAN MD
Active
Organization
TARIQ ALI KHAN MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARIQ ALI KHAN MD (OWNER)
(657) 218-9859
Entity
Organization
Contact information
Practice address
14642 NEWPORT AVE, SUITE 408, TUSTIN, CA 92780-6057
(657) 218-9859
(657) 218-4023
Mailing address
14642 NEWPORT AVE, SUITE 408, TUSTIN, CA 92780-6057
(657) 218-9859
(657) 218-4023
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A112661
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295925253
NPI INDIVIDUAL
CA
Enumeration date
07/25/2016
Last updated
06/11/2024
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