Most Relevant Information
Provider Data
| NPI Number: | 1003664988 |
| Provider Name: | MAHNAM KHIZER M.B.B.S |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/07/2024 |
| Last Updated: | 08/05/2024 |
Provider Practice Location
400 W. 16TH STREET
PUEBLO
CO
81003
Practice Location Phone/Fax
| Phone: | 7195844561 |
| Fax: | 7195442741 |
Provider Mailing Location
1915 N GREENWOOD ST
PUEBLO
CO
81003
Provider Mailing Phone/Fax
| Phone: | 7197449669 |
| Fax: | 7195442741 |