| Tanzim Khan, DPM | |
|
1520 San Pablo St Ste 4300, Los Angeles, CA 90033-5330 | |
| (323) 442-5849 | |
| Not Available |
| Full Name | Tanzim Khan |
|---|---|
| Gender | Male |
| Speciality | Podiatrist |
| Location | 1520 San Pablo St Ste 4300, Los Angeles, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316344138 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | 25MD00337300 (New Jersey) | Secondary |
| 213E00000X | Podiatrist | N006848-1 (New York) | Secondary |
| 213E00000X | Podiatrist | E5403 (California) | Primary |
| Provider Name | Dewan S. Khan M.d.,p.c. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1104994649 PECOS PAC ID: 5991875536 Enrollment ID: O20080609000285 |
| Mailing Address | Practice Location Address |
|---|---|
| Tanzim Khan, DPM Po Box 31309, Los Angeles, CA 90031-0309 Ph: (323) 442-5849 | Tanzim Khan, DPM 1520 San Pablo St Ste 4300, Los Angeles, CA 90033-5330 Ph: (323) 442-5849 |
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