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Organization
MANSURUR R. KHAN M.D. INC.
Active
Organization
MANSURUR R. KHAN M.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANSURUR R KHAN M.D. (PRESIDENT)
(323) 359-5610
Entity
Organization
Contact information
Practice address
255 E BONITA AVE, STE 101 BUILDING 101, POMONA, CA 91767-1923
(323) 359-5610
Mailing address
1738 VELTO WAY, UPLAND, CA 91784-9273
(323) 359-5610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A72399
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A72399
LICENSE NUMBER
CA
Enumeration date
11/16/2012
Last updated
12/20/2013
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