Provider Demographics
NPI:1184063604
Name:HARRY A. KHASIGIAN A MEDICAL CORPORATION
Entity type:Organization
Organization Name:HARRY A. KHASIGIAN A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACT/CODING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:M
Authorized Official - Last Name:OCHOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-525-0620
Mailing Address - Street 1:7551 TIMBERLAKE WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5420
Mailing Address - Country:US
Mailing Address - Phone:916-525-0620
Mailing Address - Fax:916-525-0639
Practice Address - Street 1:7551 TIMBERLAKE WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5420
Practice Address - Country:US
Practice Address - Phone:916-525-0620
Practice Address - Fax:916-525-0639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG297720174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G297720Medicare UPIN