Individual
DR. GAURAV KHANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8008 FROST ST STE 401, SAN DIEGO, CA 92123-4209
(858) 650-5036
(858) 650-5039
Mailing address
5585 SHANNON RIDGE LN, SAN DIEGO, CA 92130-4810
(443) 824-3660
(858) 650-5039
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35089734
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35.089734
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
C167024
CA
207RP1001X
Pulmonary Disease Physician
35.089734
OH
207RP1001X
Pulmonary Disease Physician
Primary
C167024
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35.089734
STATE LICENSE
OH
01
—
C167024
STATE LICENSE
CA
Enumeration date
11/05/2007
Last updated
09/28/2022
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