| Ksk Nursing Corporation | |
|
1875 W Redondo Beach Blvd Ste 308 Gardena CA 90247-3644 | |
| (310) 387-2054 | |
| Not Available |
| Full Name | Ksk Nursing Corporation |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1875 W Redondo Beach Blvd Ste 308, Gardena, California |
| Authorized Official Name and Position | Khadeer Khan (DIRECTOR) |
| Authorized Official Contact | 3103872054 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ksk Nursing Corporation 506 Phelan Ln Redondo Beach CA 90278-5309 Ph: (310) 387-2054 | Ksk Nursing Corporation 1875 W Redondo Beach Blvd Ste 308 Gardena CA 90247-3644 Ph: (310) 387-2054 |
| NPI Number | 1497503130 |
|---|---|
| Provider Enumeration Date | 05/08/2024 |
| Last Update Date | 11/27/2024 |
| Medicare PECOS PAC ID | 8022551985 |
|---|---|
| Medicare Enrollment ID | O20240619002357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497503130 | NPI | - | NPPES |
| Provider Name | Khadeer A Khan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588964456 PECOS PAC ID: 1658523279 Enrollment ID: I20121206000106 |
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