Individual
DR. ILYA L KHAMISHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1650 CREEKSIDE DR STE 170, FOLSOM, CA 95630-3400
(916) 986-4426
(916) 986-4434
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
A54344
CA
Other
Enumeration date
12/05/2005
Last updated
04/14/2025
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