Organization
AHURA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKAN KHATIBI DO (CEO)
(949) 842-9628
Entity
Organization
Contact information
Practice address
29911 NIGUEL ROAD, UNIT 6429, LAGUNA NIGUEL, CA 92607-2417
(951) 523-8111
(888) 873-6220
Mailing address
27188 SUN CITY BLVD, SUN CITY, CA 92586-5505
(951) 523-8111
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/19/2020
Last updated
08/17/2021
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