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Individual

DR. ALI A. KHAKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3100 NE 28TH ST STE E, LINCOLN CITY, OR 97367-4524
(541) 994-8114
Mailing address
PO BOX 1194, CORVALLIS, OR 97339-1194

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD23308
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
074703
OR
Enumeration date
06/04/2006
Last updated
11/04/2020
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