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Individual

GAUHAR R KHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1409 E BRIGGSMORE AVE, MODESTO, CA 95355
(209) 550-4750
(209) 572-1187
Mailing address
10470 OLD PLACERVILLE RD STE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071

Taxonomy

Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
A102895
CA
207RI0011X
Interventional Cardiology Physician
MD25690
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
278082
OR
01
P00250897
RAILROAD MEDICARE
Enumeration date
12/21/2006
Last updated
08/26/2019
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