Individual
KHADEER KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, DNP, FNP, PMHNP
Contact information
Practice address
1875 W REDONDO BEACH BLVD STE 308, GARDENA, CA 90247-3644
(310) 387-2054
(310) 362-3598
Mailing address
506 PHELAN LN, REDONDO BEACH, CA 90278-5309
(310) 387-2054
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
19864
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
19864
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195UT0EB
—
CA
Enumeration date
10/26/2010
Last updated
11/27/2024
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