Individual
ATUL K. KHANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2185 W GRANT LINE RD, TRACY, CA 95377-7309
(209) 839-3200
Mailing address
1800 HARRISON ST FL 7, OAKLAND, CA 94612-3466
(510) 625-6262
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A66763
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A667630
—
CA
Enumeration date
11/01/2006
Last updated
12/13/2021
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