Provider Demographics
NPI:1194811778
Name:KHALIFA, EL RASHEED (DDS)
Entity type:Individual
Prefix:
First Name:EL RASHEED
Middle Name:
Last Name:KHALIFA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 W YOSEMITE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-5165
Mailing Address - Country:US
Mailing Address - Phone:209-823-9346
Mailing Address - Fax:209-823-1899
Practice Address - Street 1:1509 W YOSEMITE AVE STE B
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-5165
Practice Address - Country:US
Practice Address - Phone:209-823-9346
Practice Address - Fax:209-823-1899
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40630122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist