Organization
KAMYAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHMOOD KHAN MD (MANAGER/CEO)
(928) 279-9079
Entity
Organization
Contact information
Practice address
2002 N STOCKTON HILL RD STE 104, KINGMAN, AZ 86401-4698
(928) 692-1010
(928) 692-7070
Mailing address
1720 E BEVERLY AVE STE 1-B, KINGMAN, KINGMAN, AZ 86409-3567
(928) 692-1010
(928) 692-7070
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z137853
PTAN
AZ
Enumeration date
05/20/2010
Last updated
02/16/2018
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