Organization
AMERICAN ADVANCED GASTROENTEROLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD HUMAYOUN KHAN MD (PRESIDENT)
(312) 224-8764
Entity
Organization
Contact information
Practice address
173 E WEBSTER ST, COLUSA, CA 95932-2949
(209) 857-4787
(209) 248-7856
Mailing address
4120 DALE RD # J8-140, MODESTO, CA 95356-9232
(209) 857-4787
(209) 248-7856
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A35408
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A35408
MEDICAL BOARD OF CALIFORNIA
CA
Enumeration date
01/29/2018
Last updated
06/16/2018
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