Provider Demographics
NPI:1215280870
Name:KHOSHABA, LINDA (NMD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:KHOSHABA
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 E PINNACLE PEAK RD STE A109
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3409
Mailing Address - Country:US
Mailing Address - Phone:480-500-1834
Mailing Address - Fax:833-605-1101
Practice Address - Street 1:7500 E PINNACLE PEAK RD STE A109
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3409
Practice Address - Country:US
Practice Address - Phone:480-500-1834
Practice Address - Fax:833-605-1101
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12-1330175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath