Individual
AFSANEH KHALILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4400 DUCKHORN DR, SACRAMENTO, CA 95834-2589
(916) 575-8000
(916) 575-8099
Mailing address
3400 DATA DR, CREDENTIALING, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A63303
CA
207R00000X
Internal Medicine Physician
Primary
A63303
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A633030
BLUE SHIELD PROVIDER NO.
CA
01
—
954877490
BLUE CROSS PROVIDER ID
CA
Enumeration date
12/20/2006
Last updated
11/30/2021
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