Khamishon, Ilya

Khamishon, Ilya is an individual health care provider with primary practice located at 4304 Esplanade Cir. , Folsom CA 95630. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Khamishon, Ilya can be contacted via phone (916) 217-4592.

Contact Information

Primary practice address
4304 Esplanade Cir. Folsom CA 95630
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A054344 California

Profile Details

NPI number 1275517062
LBN Legal business name Khamishon, Ilya
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Jul 1st, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275517062 NPPES
California MEDICAID 00A543440

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